Managing ANCA-associated vasculitis during the COVID-19 pandemic: results from an online survey

Rheumatol Int. 2021 Nov;41(11):1941-1947. doi: 10.1007/s00296-021-04975-4. Epub 2021 Aug 24.

Abstract

Management of ANCA-associated vasculitis (AAV) during the COVID-19 pandemic poses unique therapeutic challenges. An online survey was conducted to understand physician's choices for treating AAV during the COVID-19 pandemic. Web-based survey featuring nineteen questions was circulated amongst physicians across various specialties. The responses regarding immunosuppressive therapy for remission induction and maintenance, COVID-19 testing, and preventive measures were recorded. A total of 304 responses were recorded. Most of the respondents were from India (83.9%) and comprised rheumatologists (66%) in practice for ≥ 5 years (71%). Though a majority preferred Rituximab or intravenous cyclophosphamide (CYC) as a remission induction agent, a significant proportion opted for oral CYC and mycophenolate mofetil (MMF) also. Only one-third wanted to test for COVID-19 before initiating immunosuppressive therapy in patients with organ/life-threatening manifestations. Rituximab was the most favored maintenance therapy (47%), followed by azathioprine, MMF, and methotrexate. The results of this focused survey of managing AAV patients depict the real-world dilemmas and physicians' choices in this setting.

Keywords: ANCA-associated vasculitis; Agents; COVID-19; Immunosuppressive; Online survey.

MeSH terms

  • Adult
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / drug therapy*
  • COVID-19 / epidemiology
  • COVID-19 Testing
  • Female
  • Humans
  • Immunosuppression Therapy / methods*
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Pandemics
  • Practice Patterns, Physicians'*
  • Remission Induction / methods
  • Rheumatology / methods*
  • SARS-CoV-2
  • Surveys and Questionnaires

Substances

  • Immunosuppressive Agents