PMID- 27872452
OWN - NLM
STAT- MEDLINE
DCOM- 20170425
LR  - 20220330
VI  - 126
IP  - 10
DP  - 2016 Oct 28
TI  - How to treat ANCA‑associated vasculitis: practical messages from 2016 
      EULAR/ERA‑EDTA recommendations.
PG  - 781-788
LID - 10.20452/pamw.3598 [doi]
AB  - The European League against Rheumatism (EULAR) with the European Renal 
      Association - European Dialysis and Transplant Association recently published an 
      update of 2009 EULAR recommendations with a focus on the management of 
      antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV). In this 
      article, we discuss the following key messages for clinical practice derived from 
      these recommendations: 1) biopsy should be performed if possible to confirm new 
      diagnosis or relapse; 2) glucocorticoid therapy is an extremely important adjunct 
      to the management of AAV, but it is also responsible for the majority of adverse 
      effects; the dose should be tapered to 7.5 to 10 mg/d at 3 to 5 months; 3) 
      cyclophosphamide or rituximab are the mainstay of remission induction; 4) 
      patients with major relapse should be treated like those with new disease, but 
      rituximab is the preferred option in those patients who relapse after prior 
      cyclophosphamide; 5) minor relapse should not be treated with glucocorticoid 
      alone, and a change in immunosuppressive regimen should be considered; 6) 
      rituximab can be used not only for remission induction but also for maintenance; 
      7) maintenance therapy should continue for at least 2 years, after which gradual 
      taper could be considered; 8) while ANCA are extremely useful for diagnosis and 
      rising ANCA levels seem to be associated with relapse, serial monitoring should 
      not guide treatment decisions; 9) monitoring of AAV patients should be holistic 
      with a structured assessment tool and monitoring for effects related to the 
      vasculitis as well as treatment; 10) management should be either at or in 
      conjunction with an expert center; and 11) patients should be involved in 
      decision making and have access to educational resources.
FAU - Sznajd, Jan
AU  - Sznajd J
FAU - Mukhtyar, Chetan
AU  - Mukhtyar C
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20161028
PL  - Poland
TA  - Pol Arch Med Wewn
JT  - Polskie Archiwum Medycyny Wewnetrznej
JID - 0401225
SB  - IM
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis/*drug 
      therapy
MH  - Europe
MH  - Humans
MH  - Middle Aged
MH  - Practice Guidelines as Topic
MH  - Societies, Medical
EDAT- 2016/11/23 06:00
MHDA- 2017/04/26 06:00
CRDT- 2016/11/23 06:00
PHST- 2016/11/23 06:00 [entrez]
PHST- 2016/11/23 06:00 [pubmed]
PHST- 2017/04/26 06:00 [medline]
AID - 10.20452/pamw.3598 [doi]
PST - ppublish
SO  - Pol Arch Med Wewn. 2016 Oct 28;126(10):781-788. doi: 10.20452/pamw.3598. Epub 
      2016 Oct 28.