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Steroid-free management and recent advances in antineutrophil cytoplasmic antibody-associated vasculitis

1 Department of Rheumatology; Department of Medicine, University Hospitals Limerick, Limerick, Ireland
2 Department of Medicine, University Hospitals Limerick, Limerick, Ireland

Correspondence Address:
Fahd Adeeb,
Department of Rheumatology, UL Hospitals Group, Dooradoyle, Limerick
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/injr.injr_87_22

Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) represents one of the most challenging and potentially life-threatening conditions faced by rheumatologists. Part of the challenge has been the limited therapeutic options available and the substantial concern related to their toxicity, which are time dependent and dose dependent. Systemic glucocorticoids (GC) have been the cornerstone of AAV therapy since the 1950s; however, the extensive list of risks associated with its use are well described. Cyclophosphamide and rituximab have become the standard therapy for remission induction in organ or life-threatening AAV but not all patients achieve or sustain remission and many remain on long-term GC therapy. Recent attention focuses on achieving sustainable steroid-free induction and remission maintenance through transformative innovation of novel drug development or repurposing. This review sheds light on the significant advances made in similar or more effective novel innovative steroid-sparing or reduction strategies in AAV.

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