On May 6, the U.S. Food & Drug Administration’s (FDA’s) Arthritis Advisory Committee narrowly voted in support of avacopan, a C5a receptor inhibitor, for the treatment of adult patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. Although the panelists were excited about the possibility of a steroid-sparing therapy, some raised questions about whether results from…
In a small study, patients with GCA maintained remission after receiving three days of treatment with methylprednisolone followed by tocilizumab.
NEW YORK (Reuters Health)—Tocilizumab induced a slow and lasting remission after an ultra-short pulse (three days) of steroids in newly diagnosed giant cell arteritis (GCA) patients, a proof-of-concept trial shows.1 His early research on cytokines and glucocorticoids led Peter Villiger, MD, of Medical Center Monbijou, Bern, Switzerland, to find ways to reduce steroid use, he…
ATLANTA—The American College of Rheumatology (ACR), in partnership with the Vasculitis Foundation (VF), released three new guidelines for the treatment and management of systemic vasculitis. Vasculitis is a group of about 20 rare diseases that have inflammation of blood vessels in common, which can restrict blood flow and damage vital organs. The three guidelines cover…
Vision loss, implications of treatment and more—Sarah Mackie, BMBCh, PhD, MRCP, discussed the latest research on the evaluation and management of giant cell arteritis.
In September 2019, a previously healthy, 9-year-old white girl presented to the emergency department following two months of sinusitis and unexplained fever responsive to ibuprofen. She presented with anorexia; a 9 lb. weight loss; intermittent, nonbilious, nonbloody emesis; and occasional epistaxis with digital manipulation of the nose. Six weeks prior to admission, she had presented to…
Many a rheumatology consult has centered on a perplexing question: Does this patient have central nervous system (CNS) vasculitis? At the 2021 ACR State-of-the-Art Clinical Symposium, Rula Hajj-Ali, MD, FACP, professor of medicine and associate director of vasculitis care and research, Cleveland Clinic Lerner College of Medicine, discussed this topic in detail, providing a series…
Calciphylaxis, or calcific uremic arteriolopathy, is a rare disease characterized by calcification of the arterioles and capillaries in the dermis and subcutaneous tissue, resulting in thrombus formation and subsequent skin ischemia and necrosis.1 This serious condition most commonly occurs in patients with end-stage renal disease (ESRD) requiring dialysis or in kidney transplant recipients. In rare…
A phase 3 trial described in The New England Journal of Medicine (NEJM) highlights the potential of a C5a receptor inhibitor, avacopan, for anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis.1 Avacopan may potentially offer a steroid-sparing option for the treatment of this serious disease. Current Treatment of ANCA-Associated Vasculitis Morbidity and mortality from ANCA-associated vasculitis have…
The ACR, in concert with the Vasculitis Foundation, released three new vasculitis guidelines online first in July, with a fourth slated for publication by the end of the year. These are the first ever to be produced and endorsed by the ACR and the Vasculitis Foundation. Although most of the recommendations are conditional, due to…