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Risks and rewards of treating elderly patients with vasculitis

Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis is a common cause of acute kidney injury in the elderly. This patient group is particularly susceptible to disease-related morbidity and mortality, and to adverse effects of induction immunosuppression. A new study adds to the debate on the most appropriate way to treat this vulnerable group of patients.

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  1. 1

    Moutzouris, D. A. et al. Renal biopsy in the very elderly. Clin. J. Am. Soc. Nephrol. 4, 1073–1082 (2009).

    CAS  Article  Google Scholar 

  2. 2

    Harper, L. & Savage, C. O. ANCA-associated renal vasculitis at the end of the twentieth century—a disease of older patients. Rheumatology (Oxford) 44, 495–501 (2005).

    CAS  Article  Google Scholar 

  3. 3

    Chen, M., Yu, F., Zhang, Y. & Zhao, M. H. Antineutrophil cytoplasmic autoantibody-associated vasculitis in older patients. Medicine (Baltimore) 87, 203–209 (2008).

    CAS  Article  Google Scholar 

  4. 4

    Little, M. A. et al. Early mortality in systemic vasculitis: relative contribution of adverse events and active vasculitis. Ann. Rheum. Dis. 69, 1036–1043 (2010).

    Article  Google Scholar 

  5. 5

    Flossman, O. et al. Long-term patient survival in ANCA-associated vasculitis. Ann. Rheum. Dis. 70, 488–494 (2011).

    Article  Google Scholar 

  6. 6

    Mukhtyar, C. & Luqmani, R. Disease-specific quality indicators, guidelines, and outcome measures in vasculitis. Clin. Exp. Rheumatol. 25 (Suppl. 47), 120–129 (2007).

    CAS  PubMed  Google Scholar 

  7. 7

    Bomback, A. S. et al ANCA-associated glomerulonephritis in the very elderly. Kidney Int. doi:10.1038/ki.2010.489.

  8. 8

    de Groot, K. et al. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial. Ann. Intern. Med. 150, 670–680 (2009).

    Article  Google Scholar 

  9. 9

    Stone, J. H. et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N. Engl. J. Med. 363, 221–232 (2010).

    CAS  Article  Google Scholar 

  10. 10

    Jones, R. B. et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N. Engl. J. Med. 363, 211–220 (2010).

    CAS  Article  Google Scholar 

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Correspondence to Charles D. Pusey.

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The authors declare no competing financial interests.

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Tarzi, R., Pusey, C. Risks and rewards of treating elderly patients with vasculitis. Nat Rev Nephrol 7, 253–255 (2011).

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