How do you approach management of rheumatoid vasculitis (in this era)?

We don't see rheumatoid vasculitis very often nowadays. When our drug options for RA were limited, most patients had smoldering ongoing disease, which predisposed them to the possible development of a rheumatoid arthritis related vasculitis, though even then, cases were uncommon.

Nowadays, our abili...

I usually start with steroids, then add methotrexate, and last add rituxan.

I agree with Dr. @Dr. First Last overall but would characterize the type of vasculitis to aid in choosing the drug of choice. In general, rituximab is the best choice, but occasionally associated large vessel vasculitis (Takayasu phenotype) can be managed successfully with tocilizumab. A small vesse...