The combination of omalizumab and mepolizumab has “done wonders” for her EGPA as well, she said, and finally allowed her to taper off prednisone. “I’ve got a great team now,” she said, but she noted that she shopped around and assembled the providers on her own. Nevertheless, Ms. Brechtelsbauer said she feels lucky to be alive. “Right now, I’m doing great,” she said. “Biologics saved my life.” In addition to her wife and caregiver, Cheryl, she said, Facebook groups, national meetings and the Vasculitis Foundation have been strong pillars of support, especially given her ultra-rare disease. “To find your little tribe within that is amazing,” she said.
Advances on 3 Fronts
In his opening talk, Dr. Seo grouped the emerging vasculitis therapies into three main categories: selective immune cell depletion, cytokine-based strategies and inhibition of immune targeting. Rituximab, in the first category, is a monoclonal anti-CD20 antibody that destroys B cells tagged with the CD-20 cell surface marker. B cell strategies are now standard for the treatment of both MPA and GPA (granulomatosis with polyangiitis). The two forms of ANCA-associated vasculitis attack small blood vessels, mainly in the lungs and kidneys. Rituximab received FDA approval to treat both conditions in 2011, and the drug is now used to treat cryoglobulinemic vasculitis, as well.
The second main treatment category, cytokine-based strategies, can “prevent the immune system from ganging up on you,” Dr. Seo said. Because cytokines instigate immune cells, targeting them can prevent a misguided attack. The pro-inflammatory cytokine IL-6, for example, spurs the production of infection-
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