Vasculitis steroid treatment

The exact role of vascular imaging with respect to monitoring of disease activity and prediction of disease relapse has not clearly been defined in giant cell arteritis. For this reason, patients with giant cell arteritis who are enrolled in the GiACTA trial can participate in a positron emission tomography-computed tomography (PET/CT) substudy. Selected patients will undergo a PET/CT of the neck, chest, abdomen and pelvis after one year of treatment to scan the large arteries for radiographic evidence of vascular inflammation. The goal of this substudy is to determine the proportion of patients with radiographic activity and the correlation of radiographic findings with the risk of subsequent disease relapse.

Hypersensitivity vasculitis primarily affects postcapillary venules and arterioles of the skin. This disorder usually presents as palpable purpura, although lesions may occasionally be urticarial or ulcerative ( Figure 2 ) . Skin biopsy usually shows leukocytoclastic angiitis. Although hypersensitivity vasculitis is occasionally idiopathic, there are multiple known etiologies, including medications, infections, malignancy and primary connective tissue diseases. If hypersensitivity vasculitis is suspected, diagnostic evaluation should focus on identifying an underlying cause and on looking for other organ involvement and large-vessel involvement, which may require more aggressive treatment.

Rheumatologists are usually the specialists with the most overall knowledge about vasculitis. Thus, they direct the care of patients, particularly those with chronic or severe disease. Patients with vasculitis often benefit from seeing experts in the organ systems that are or might become affected. Doctors that patients may need to see include a dermatologist (skin doctor), neurologist (expert in nervous system diseases), ophthalmologist (eye doctor), otorhinolaryngologist (ear, nose and throat doctor), nephrologist (kidney doctor) or pulmonologist (lung doctor).

In the current study, the researchers followed trial participants for an additional year to evaluate rituximab’s long-term efficacy and safety. After 18 months, rituximab continued to be as effective as the standard regimen, with 39 percent of participants who received rituximab and 33 percent of those who received standard care showing no signs of active disease. There were no major differences between the two groups in average length of remission or in the frequency and severity of relapses. Adverse events, such as infection, occurred at a similar rate in both groups during the 18 months.

Vasculitis steroid treatment

vasculitis steroid treatment

In the current study, the researchers followed trial participants for an additional year to evaluate rituximab’s long-term efficacy and safety. After 18 months, rituximab continued to be as effective as the standard regimen, with 39 percent of participants who received rituximab and 33 percent of those who received standard care showing no signs of active disease. There were no major differences between the two groups in average length of remission or in the frequency and severity of relapses. Adverse events, such as infection, occurred at a similar rate in both groups during the 18 months.

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