Autoimmune

Question 1

How do we treat ANCA vasculitis?

Answer 1

1. Remission induction: Cyclophosphamide (destroys B/T cells, preventing antibody production) and steroids = strong drugs for 3-6 months
2. Maintenance of remission: Azothioprine and steroids - slightly weaker drugs forever

This is a relapsing disease, 50% of people relapse within 10 years.

Other treatments:
Methotrexate - slightly less toxic
Mycophenalate
Mofetil
Rituximab - kills B cells

For severe presentations, and those on dialysis:
Plasma exchange - exchanges the plasma for plasma without the ANCA-producing lymphocytes present