Biological therapies: new treatment options for ANCA-associated vasculitis?

Abstract

Biological therapies enable us to apply highly selective targeting components to modulate the immune response. Until now, a few controlled studies investigated the efficacy of TNF-alpha blocking agents in systemic vasculitis have been carried out, but, in general, they were falling short of expectations. However, there is conducive evidence that TNF-alpha blockers are advantageous in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, at least in selected disease stages. Likewise, although the efficacy of the monoclonal CD20 antibody rituximab in ANCA-associated vasculitis is obvious, the effect on predominantly granulomatous disease activity in Wegener's granulomatosis is less clear. In addition, interferon-alpha is used for induction treatment particularly in Churg-Strauss syndrome. Even though the effectiveness and safety of short-term administration was confirmed by case series, severe side effects after long-term treatment relativized the initial results. This review presents the recent data on the use of biologicals in vasculitis and appraises the knowledge in the clinical context.

• Authors: Peer M Aries, Peter Lamprecht, Wolfgang L Gross
• Journal: Expert opinion on biological therapy (Expert Opin Biol Ther) Vol. 7 Issue 4 Pg. 521-33 (Apr 2007) ISSN: 1744-7682 [Electronic] England
• PMID: 17373903 (Publication Type: Journal Article, Review)

Chemical References

• Antibodies, Antineutrophil Cytoplasmic
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Antirheumatic Agents
• Immunoglobulin G
• Immunologic Factors
• Interferon-alpha
• Receptors, Tumor Necrosis Factor
• Tumor Necrosis Factor-alpha
• Rituximab
• Infliximab
• Etanercept

Topics

• Antibodies, Antineutrophil Cytoplasmic (adverse effects, immunology, physiology)
• Antibodies, Monoclonal (adverse effects, blood, therapeutic use)
• Antibodies, Monoclonal, Murine-Derived
• Antirheumatic Agents (adverse effects, therapeutic use)
• Biological Therapy (methods)
• Churg-Strauss Syndrome (drug therapy)
• Etanercept
• Granulomatosis with Polyangiitis (drug therapy, etiology, physiopathology)
• Humans
• Immunoglobulin G (adverse effects, blood, therapeutic use)
• Immunologic Factors (therapeutic use)
• Infliximab
• Interferon-alpha (therapeutic use)
• Randomized Controlled Trials as Topic
• Receptors, Tumor Necrosis Factor (blood, therapeutic use)
• Rituximab
• Tumor Necrosis Factor-alpha (antagonists & inhibitors, blood, immunology)
• Vasculitis (drug therapy, etiology, immunology)