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Nephrol Dial Transplant (2001) 16: 1314-1317
© 2001 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

New aspects in the management of ANCA-positive vasculitis

Jeremy Levy

Renal Section, Imperial College School of Medicine, Hammersmith Hospital, Ducane Road, London, UK

Keywords: ANCA; cyclophosphamide; immunosuppression; intravenous immunoglobulin; leflunomide; mycophenolate mofetil

Introduction

Vasculitides associated with anti-neutrophil cytoplasm antibody (ANCA) are increasingly recognized. Over the last decade there has been a concerted attempt at clarifying definitions of vasculitis [1], improving diagnosis on the basis of serological testing [2], and determining disease activity by scoring systems [3]. The next major developments will be in identifying treatment strategies best suited to different disease states, and in particular those that minimize treatment toxicity. The importance of distinguishing initial acute disease from chronic phases of vasculitis has become increasingly clear, and different regimens are necessary during induction and maintenance phases of treatment. The current European multi-centre controlled trials, coordinated by the European Vasculitis Study Group (EUVAS) (due to report over the next few years), will provide more definitive answers to some of the most difficult questions with respect to the treatment of patients with ANCA-associated vasculitis [4]. However, over . . . [Full Text of this Article]

Old drugs: new data

Cyclophosphamide
Plasma exchange
Cyclosporin
Old drugs—new uses

Intravenous immunoglobulin
Methotrexate
New drugs—new uses

Mycophenolate (MMF)
Deoxyspergualin (DSG)
Leflunomide
Entirely new approaches
Conclusion

Notes

References


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