Evolving Treatments
The results of RITAZAREM, PEXIVAS and ADVOCATE are expected to have a major impact on the approach physicians and patients take to the treatment of AAV.
“Studying the comparative effectiveness of varying glucocorticoid dosing schedules and steroid-sparing regimens in AAV is challenging but can be done and is being done,” Dr. Merkel said. “Ongoing and planned trials in AAV will continue to lead toward safer and more effective therapies for this form of vasculitis and provide increasing benefit to patients.”
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Kimberly Retzlaff is a freelance medical journalist based in Denver.
References
- Guillevin L, Pagnoux C, Karras A, et al. Rituximab versus azathioprine for maintenance in ANCA-associated vasculitis. N Engl J Med. 2014 Nov 6;371(19):
1771–1180. - Barnard C. Support for rituximab maintenance therapy in ANCA-associated vasculitis. medwireNews. 2019 Nov 10.
- Smith R, Jayne D, Merkel P. A randomized, controlled trial of rituximab versus azathioprine after induction of remission with rituximab for patients with ANCA-associated vasculitis and relapsing disease [abstract]. Arthritis Rheumatol. 2019;71(suppl 10).
- Walsh M, Catapano F, Szpirt W, et al. Plasma exchange for renal vasculitis and idiopathic rapidly progressive glomerulonephritis: A meta-analysis. Am J Kidney Dis. 2011 Apr;57(4):566–574.
- Walsh M, Merkel PA, Peh C-A, et al. Plasma exchange and glucocorticoids in severe ANCA-associated vasculitis. N Engl J Med. 2020 Feb 13;382(7):622–631.
- Jayne DRW, Bruchfeld AN, Harper L, et al. Randomized trial of C5a receptor inhibitor avacopan in ANCA-associated vasculitis. J Am Soc Nephrol. 2017 Sep;28(9):2756–2767.
- ChemoCentryx and VFMCRP announce positive topline data from pivotal phase III ADVOCATE Trial demonstrating avacopan’s superiority over standard of care in ANCA-associated vasculitis (press release). 2019 Nov 25.