TY - JOUR T1 - Response to: ‘Prevention of infections in patients with antineutrophil cytoplasm antibody-associated vasculitis: potential role of hydroxychloroquine’ by Novikov <em>et al</em> JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - e20 LP - e20 DO - 10.1136/annrheumdis-2018-214735 VL - 79 IS - 2 AU - Andreas Kronbichler AU - David Jayne Y1 - 2020/02/01 UR - http://ard.bmj.com/content/79/2/e20.abstract N2 - We thank Dr Novikov et al for their letter on the risk of infections of patients with antineutrophil cytoplasm antibody (ANCA)-associated vasculitis and the proposed beneficial effects of hydroxychloroquine (HCQ) to reduce severe infections, as a response to our recently published article ‘Trimethoprim-sulfamethoxazole prophylaxis prevents severe/life-threatening infections following rituximab in antineutrophil cytoplasm antibody-associated vasculitis’.1 2 Modern therapies and adoption of treatment protocols have improved outcome of patients with ANCA-associated vasculitis. Morbidity and mortality, either attributable to the disease or immunosuppressive measures, remain a challenge for the treating physician. A recent meta-analysis of observational studies found a 2.7-fold increased risk of death with a trend towards improved mortality rates in more recent cohorts.3 Among patients recruited into the ‘early trials’ conducted by the European Vasculitis Society (EUVAS), 133 (25%) deaths were recorded over a median follow-up period of 5.2 years. Main causes for death were infections (48%) and active vasculitis (19%) in the first year, while infectious complications remained one of the leading complications leading to mortality (20%) thereafter. Moreover, infections were the leading contributing factor of mortality in this period.4 Several risk factors leading to infections have been identified in … ER -