Skip to main content

General Principles of Treatment

  • Chapter
  • First Online:
Book cover Vasculitis in Clinical Practice

Abstract

The type of vasculitis and the extent of organ involvement guide treatment. The intensity of initial immunosuppression depends on the severity of organ involvement and the size of the vessels involved (Table 4.1). Therefore, an important part of treatment planning involves the assessment of organ involvement and its severity. Treatment may be divided into remission induction, maintenance, and long-term follow-up. Guidelines on the management of the vasculitides have been recently published. In this chapter, we will cover the general principles of treatment and the agents used.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lapraik C, Watts RA, Scott DG. BSR and BHPR guidelines for the management of adults with ANCA associated vasculitis. Rheumatology. 2007;46:1615-1616.

    Article  PubMed  CAS  Google Scholar 

  2. Mukhtyar C, Guillevin L, Cid M, et al. EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2009;68:318-323.

    Article  PubMed  CAS  Google Scholar 

  3. Mukhtyar C, Guillevin L, Cid M, et al. EULAR recommendations for the management of primary small and medium vasculitis. Ann Rheum Dis. 2009;68:310-317.

    Article  PubMed  CAS  Google Scholar 

  4. Jayne D, Rasmussen N, Andrassy K, et al. A randomised trial of maintenance therapy for vasculitis associated with antineutrophil cytoplasmic auto antibodies. N Engl J Med. 2003;349:36-44.

    Article  PubMed  CAS  Google Scholar 

  5. Pagnoux C et al. Azathioprine or methotrexate maintenance for ANCA-associated vasculitis. N Engl J Med. 2008;359:2790-2803.

    Article  PubMed  CAS  Google Scholar 

  6. Koukoulaki M, Jayne DRW. Mycophenolate mofetil in anti-neutrophil cytoplasm antibodies-associated systemic vasculitis. Nephron Clin Pract. 2006;102:c100-c110.

    Article  PubMed  CAS  Google Scholar 

  7. Metzler C et al. Elevated relapse rate under oral methotrexate versus leflunomide for maintenance of remission in Wegener’s granulomatosis. Rheumatology. 2007;46:1087-1091.

    Article  PubMed  CAS  Google Scholar 

  8. Falk RJ, Jennette JC. Rituximab in ANCA-associated disease. New Engl J Med. 2010;363:285-286.

    Article  PubMed  CAS  Google Scholar 

  9. The Wegener’s Granulomatosis Etanercept Trial (WGET) Research Group. Etanercept plus standard therapy for Wegener’s granulomatosis. N Engl J Med. 2005;352:351-361.

    Article  Google Scholar 

  10. de Groot K, Harper L, Jayne DR, et al. Pulse versus oral cyclophosphamide for induction of remission in anti-neutrophil cytoplasmic antibody associated vasculitis: a randomised trial. Ann Intern Med. 2009;150:670-680.

    Article  PubMed  Google Scholar 

  11. de Groot K, Rasmussen N, Bacon P, et al. Randomised trial of cyclophosphamide versus methotrexate for induction of remission in early systemic antineutrophil cytoplasmic antibody associated vasculitis. Arthritis Rheum. 2005;52:2462-2468.

    Article  Google Scholar 

  12. Jayne DR, Gaskin G, Rasmussen N, et al. Randomised trial of plasma exchange and high-dosage methylprednisolone as adjunctive therapy for severe renal vasculitis. J Am Soc Nephrol. 2007;18:2180-2188.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag London Limited

About this chapter

Cite this chapter

Watts, R.A., Scott, D.G.I. (2010). General Principles of Treatment. In: Watts, R., Scott, D. (eds) Vasculitis in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-84996-247-6_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-84996-247-6_4

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84996-246-9

  • Online ISBN: 978-1-84996-247-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics