Corticosteroids in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Sarah F Keller; Eli M Miloslavsky

doi:10.1016/j.rdc.2015.08.010

Corticosteroids in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Rheum Dis Clin North Am. 2016 Feb;42(1):91-101, viii. doi: 10.1016/j.rdc.2015.08.010. Epub 2015 Oct 24.

Authors

Sarah F Keller¹, Eli M Miloslavsky²

Affiliations

¹ Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
² Division of Rheumatology, Department of Medicine, Yawkey Center for Outpatient Care, Massachusetts General Hospital, Harvard Medical School, Suite 2C, Boston, MA 02114, USA. Electronic address: emiloslavsky@mgh.harvard.edu.

PMID: 26611553
DOI: 10.1016/j.rdc.2015.08.010

Abstract

Glucocorticoids (GCs) have been the cornerstone of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) therapy since their advent in the 1950s. There is considerable variation in their use, both with respect to dose and duration. Given considerable treatment-related morbidity and mortality, refining the role of GCs is becoming increasingly important. This article discusses the current role of GCs in various phases of AAV treatment, including remission induction, maintenance therapy, treatment of relapses, and the use of local GCs. It discusses current controversies relating to GC use as well as research efforts that seek to reduce GC toxicity in AAV.

Keywords: ANCA-associated vasculitis; Glucocorticoids; Granulomatosis with polyangiitis; Microscopic polyangiitis.

Publication types

Review

MeSH terms

Administration, Intravenous
Administration, Oral
Adrenal Cortex Hormones / therapeutic use
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / drug therapy
Glucocorticoids / therapeutic use*
Granulomatosis with Polyangiitis / drug therapy*
Humans
Maintenance Chemotherapy
Microscopic Polyangiitis / drug therapy*
Remission Induction
Severity of Illness Index

Substances

Adrenal Cortex Hormones
Glucocorticoids