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Int Immunopharmacol. 2015 Aug;27(2):209-12. doi: 10.1016/j.intimp.2015.04.023. Epub 2015 Apr 20.

Biological drugs in ANCA-associated vasculitis.

Author information

1
Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: pamela.lutalo@kcl.ac.uk.
2
Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, United Kingdom. Electronic address: david.dcruz@kcl.ac.uk.

Abstract

The anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitides granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA) and microscopic polyangiitis (MPA) constitute a wide spectrum of clinical manifestations of systemic vasculitis which may range from limited disease to organ or life-threatening disease. The introduction of biologics for the management of severe ANCA-associated vasculitis and severe, relapsing disease refractory to conventional immunosuppressants, has significantly improved the clinical prognosis of these autoimmune disorders. Rituximab, an anti-CD20 monoclonal antibody is licenced for remission induction in severe GPA and MPA and the management of severe relapsing, refractory GPA and MPA. Belimumab, an anti-B lymphocyte stimulatory monoclonal antibody is in clinical trials for the management of the ANCA-associated vasculitis GPA. Mepolizumab and Omalizumab are biologics which have been reported to be efficacious in refractory asthma associated with EGPA. The role of anti-TNF therapy and T cell targeting drugs in ANCA-associated vasculitis is less clear due to limited study data. This review will summarise the clinical trials and clinical practice use of biologic treatment strategies for the management of ANCA-associated vasculitis.

KEYWORDS:

ANCA; Biologics; Monoclonal antibodies; Rituximab; Vasculitis

PMID:
25907243
DOI:
10.1016/j.intimp.2015.04.023
[Indexed for MEDLINE]

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