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Discussion of the 2007 British Society for Rheumatology guidelines for management of ANCA-associated vasculitis

Nature Clinical Practice Rheumatology volume 4, pages 284–285 (2008)Cite this article

Modifications to standard treatment protocols have dramatically changed the outcomes for small-vessel and medium-vessel vasculitis over the past 20 years. This is particularly true for Wegener's granulomatosis (WG).1 A group of vasculitis experts from England and France have combined evidence from controlled trials and their own experience to propose recommendations,2 which, considering the recent advances in the field, are of great importance. The aim of the paper by Lapraik et al. is to provide guidelines for the treatment of adults with WG, microscopic polyangiitis and Churg–Strauss syndrome, all of which are grouped under the name of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. In these guidelines, they describe detailed protocols for induction of disease remission and treatment monitoring.

As stated by the authors, treatment for systemic vasculitis should be considered only if the diagnosis—made on the basis of clinical and histopathological findings—is certain, or if compelling surrogate markers of disease are present. Furthermore, before considering treatment, competing diagnoses for which therapy for systemic vasculitis could be detrimental must have been ruled out. Treatment should then be tailored according to the severity and extent of disease. To guide the clinician, the authors have classified patients as having localized or early systemic disease, generalized organ-threatening disease or severe life-threatening disease.

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References

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Authors and Affiliations

  1. A Villa-Forte is a staff member of the Center for Vasculitis Care and Research in the Department of Rheumatic and Immunologic Diseases, and GS Hoffman is Harold C Schott Chair and Professor in the Department of Rheumatic and Immunologic Diseases, both at The Cleveland Clinic Foundation, Cleveland, OH, USA.,

    Alexandra Villa-Forte & Gary S Hoffman

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  1. Alexandra Villa-Forte
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  2. Gary S Hoffman
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Correspondence to Alexandra Villa-Forte.

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The authors declare no competing financial interests.

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Villa-Forte, A., Hoffman, G. Discussion of the 2007 British Society for Rheumatology guidelines for management of ANCA-associated vasculitis. Nat Rev Rheumatol 4, 284–285 (2008). https://doi.org/10.1038/ncprheum0804

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