Details

Autor(en) / Beteiligte

• Holle, Julia U
• Moosig, Frank

Titel

Cortisone-free rheumatology-Vasculitides

Ist Teil von

• Zeitschrift für Rheumatologie, 2021-05, Vol.80 (4), p.314-321

Ort / Verlag

Germany

Erscheinungsjahr

2021

Quelle

SpringerLink

Beschreibungen/Notizen

• Glucocorticoids (GC) still represent an essential pillar of treatment in the phase of remission induction of vasculitides, which are often organ or life-threatening; however, they entail a significant potential for side effects. In the phase of remission maintenance prednisolone should be reduced to 7.5 mg/day or less. Whether a discontinuation can alway be achieved for any form of vasculitis without increasing relapse rates, is unclear. By the use of biologics, e.g. tocilizumab in giant cell arteritis (GCA), a fast tapering and discontinuation of GC seems to be more easily achievable compared to using a GC monotherapy regimen. Avacopan could in the future be an efficient agent to spare GC in the phase of remission induction in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), e.g. granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). Mepolizumab is a promising option to reduce the use of GC in eosinophilic granulomatosis with polyangiitis (EGPA).