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Antineutrophil cytoplasmic antibody-associated vasculitis : insights into relapse risk and future management directions

Alberici, Federico ; Flossmann, Oliver ; Lamprecht, Peter ; Loudon, Kevin W. ; Padoan, Roberto ; Popov, Tamara ; Salvarani, Carlo and Mohammad, Aladdin J. LU (2025) In Frontiers in Immunology 16.
Abstract

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has a relapsing-remitting course and, even with the availability of effective maintenance therapies such as rituximab, relapse rates remain high. Relapse is associated with the accrual of organ damage stemming from both the underlying disease and from the effects of AAV treatments; thus, early detection and proactive prevention are crucial. AAV study populations typically include mixed cohorts of patients with new-onset and relapsing disease. Although data specifically addressing re-induction of remission after relapse are limited, available evidence suggests high remission rates when rituximab is combined with glucocorticoids. However, the balance between effective... (More)

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has a relapsing-remitting course and, even with the availability of effective maintenance therapies such as rituximab, relapse rates remain high. Relapse is associated with the accrual of organ damage stemming from both the underlying disease and from the effects of AAV treatments; thus, early detection and proactive prevention are crucial. AAV study populations typically include mixed cohorts of patients with new-onset and relapsing disease. Although data specifically addressing re-induction of remission after relapse are limited, available evidence suggests high remission rates when rituximab is combined with glucocorticoids. However, the balance between effective disease control and the potential treatment-related side effects must be carefully considered, and new therapeutic options may help improve this tradeoff. The aim of this review is to explore what is known about relapse risk and relapse management while considering emerging pathogenic and therapeutic paradigms.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
AAV relapse, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), remission re-induction
in
Frontiers in Immunology
volume
16
article number
1655326
publisher
Frontiers Media S. A.
external identifiers
  • scopus:105017832882
  • pmid:41050707
ISSN
1664-3224
DOI
10.3389/fimmu.2025.1655326
language
English
LU publication?
yes
id
41d9175d-2e73-4b4c-9f1b-7d959451ce4c
date added to LUP
2025-12-05 14:35:42
date last changed
2025-12-06 03:00:08
@article{41d9175d-2e73-4b4c-9f1b-7d959451ce4c,
  abstract     = {{<p>Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has a relapsing-remitting course and, even with the availability of effective maintenance therapies such as rituximab, relapse rates remain high. Relapse is associated with the accrual of organ damage stemming from both the underlying disease and from the effects of AAV treatments; thus, early detection and proactive prevention are crucial. AAV study populations typically include mixed cohorts of patients with new-onset and relapsing disease. Although data specifically addressing re-induction of remission after relapse are limited, available evidence suggests high remission rates when rituximab is combined with glucocorticoids. However, the balance between effective disease control and the potential treatment-related side effects must be carefully considered, and new therapeutic options may help improve this tradeoff. The aim of this review is to explore what is known about relapse risk and relapse management while considering emerging pathogenic and therapeutic paradigms.</p>}},
  author       = {{Alberici, Federico and Flossmann, Oliver and Lamprecht, Peter and Loudon, Kevin W. and Padoan, Roberto and Popov, Tamara and Salvarani, Carlo and Mohammad, Aladdin J.}},
  issn         = {{1664-3224}},
  keywords     = {{AAV relapse; antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis; granulomatosis with polyangiitis (GPA); microscopic polyangiitis (MPA); remission re-induction}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Immunology}},
  title        = {{Antineutrophil cytoplasmic antibody-associated vasculitis : insights into relapse risk and future management directions}},
  url          = {{http://dx.doi.org/10.3389/fimmu.2025.1655326}},
  doi          = {{10.3389/fimmu.2025.1655326}},
  volume       = {{16}},
  year         = {{2025}},
}