What is your preferred regimen for remission induction and maintenance in EGPA with cardiac involvement?

Cardiac involvement in EGPA is associated with a poor prognosis and is an independent predictor of mortality. Therefore, it needs to be treated aggressively. Depending on the study, between 15-30% of EGPA patients present with or develop cardiac manifestations. The manifestations are highly variable and can include myocarditis, arrhythmia, valvular defects, heart failure, myocardial infarction, and pericardial effusion with possible tamponade. I prefer using high dose or pulse glucocorticoids along with cyclophosphamide for induction in EGPA patients with cardiac involvement. While there is increasing use of RTX in severe EGPA (though EGPA patients were not included in the RAVE or RITUXVAS trials), we have more experience using cyclophospha...