N Engl J Med 2020 Feb 13
Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis.
Related Questions
How do you determine which patients with ANCA associated vasculitis may be good candidates for reduced dose glucocorticoid tapering?
This is an important question. Currently there are several groups of patients that benefit from reduced dose glucocorticoids: The largest group are patients who are receiving avacopan for remission induction. The ADVOCATE trial demonstrated that avacopan can markedly reduce the dose of glucocorticoi...
Are there AAV patients for whom you would consider combination therapy with cyclophosphamide and rituximab?
The combination of RTX and CYC does not have a significant evidence base. The rationale for this regimen comes from the hypothesis that CYC acts quicker than RTX and can serve to quiet down the disease early and potentially spare steroids. However, there is no empirical support for this concept so f...
Is there a subset of ANCA vasculitis patients for which you would try plasma exchange?
Circling back to this now that we have more data. I agree with Dr. @Dr. First Last's main conclusion that GN or the presence of concomitant anti-GBM antibodies are the primary scenarios in which there may be a role for plasma exchange patients with ANCA-associated vasculitis.Following the PEXIVAS tr...