Evolving Therapeutic Strategies in ANCA-Associated Vasculitis: Current Standards and Emerging Targets for GPA and MPA - PubMed
4 hours ago
- #glucocorticoid-sparing therapy
- #ANCA-associated vasculitis
- #precision immunotherapy
- GPA and MPA are severe autoimmune disorders classified under ANCA-associated vasculitides (AAV).
- Standard induction therapy includes glucocorticoids (GCs) with rituximab (RTX) or cyclophosphamide (CYC), with a focus on minimizing GC use.
- Avacopan is selectively used in high-risk patients for GC toxicity.
- For maintenance therapy, fixed-interval RTX generally outperforms conventional oral agents, but treatment should be individualized.
- Challenges include treatment-related toxicity, refractory manifestations, and defining safe discontinuation strategies.
- Emerging therapies target B cells, plasma cells, complement components, and T-cell co-stimulation or cytokine networks.
- Advances aim for precision immunotherapy to achieve durable remission with reduced GC exposure and minimized long-term toxicity.