[De-escalation of therapy in ANCA-associated vasculitides].

Abstract:

:Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) require a differentiated therapeutic approach depending on the degree of organ dysfunction and disease activity. In organ dysfunction and life-threatening AAV cyclophosphamide and rituximab are recommended for the induction of remission. For remission induction with a lack of organ dysfunction and non-life-threatening AAV, methotrexate or mycophenolate mofetil are recommended. For remission maintenance therapy azathioprine or methotrexate are used. In the case of contraindications, intolerance or previous failure of azathioprine and methotrexate treatment, rituximab, leflunomide or mycophenolate mofetil may be used as alternatives. Maintenance therapy is usually continued for at least 2 years. De-escalation of therapy requires continuous clinical monitoring while the glucocorticoid medication and immunosuppressive therapy is tapered; however, every de-escalation of therapy carries a risk of relapse.

journal_name

Z Rheumatol

authors

Schinke S,Riemekasten G,Lamprecht P

doi

10.1007/s00393-016-0241-9

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

15-20

issue

1

eissn

0340-1855

issn

1435-1250

pii

10.1007/s00393-016-0241-9

journal_volume

76

pub_type

杂志文章,评审
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    authors: Krüger K,Kamilli I,Schattenkirchner M

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    authors: Schöffel J,Pohl W

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    abstract:BACKGROUND:Patients with an inflammatory disease have an elevated risk for periprosthetic joint infections due to impairment of the immune system caused by the disease itself in combination with disease-modifying antirheumatic drugs (DMARD). These infections can cause life-threatening sepsis. Unfortunately recommendati...

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  • [Visceral diseases as cause of lumbar syndromes].

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    authors: Tilscher H,Bogner G,Landsiedl F

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  • [Patient-centered evaluation of illness outcome in musculoskeletal diseases: adaptation and revision of outcome instruments].

    abstract::Assessment of disease consequences (outcome) requires reliable, valid, and sensitive instruments. Psychometrically sound generic health-status instruments such as the SF-36 have been validated for many languages and are available in German. Instead, most disease specific instruments have been developed in English and ...

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  • [Pharmacologic characteristics as the basis for differential therapy using non-steroidal anti-inflammatory agents].

    abstract::An attempt is made to compile the pharmacological data on the leading non-steroidal anti-inflammatory drugs. They concern the pharmacodynamics, the pharmacokinetics and the unwanted effects of these compounds. From these data a few suggestions for rational use are made: Ibuprofen and diclofenac present as drugs with s...

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  • [The Ha(La) antibody as a serologic marker of systemic lupus erythematosus].

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    authors: Lakomek HJ,Wagener S,Schwochau M,Krüskemper HL

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  • [Still's disease as biphasic disorder : Current knowledge on pathogenesis and novel treatment approaches].

    abstract::Still's disease covers a range of disorders from systemic juvenile idiopathic arthritis (SJIA) up to adult onset Still's disease (AOSD). The overlapping clinical features suggest that SJIA and AOSD are different manifestations of a phenotypic continuum in different age stages. Still's disease is clinically characteriz...

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  • [Essential cryoglobulinemic vasculitis with severe peripheral neuropathy and neurogenic muscular atrophy -- inducing remission by cascade filtration].

    abstract::We report on a 60 year old patient with peripheral neuropathy, neurogenic muscular atrophy, skin ulcers, arthritis and weakness. Detection of cryoglobulins in association with typical clinical symptoms, exclusion of hepatitis C and any other disease led to a rare diagnosis: essential cryoglobulinemic vasculitis. The c...

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    abstract::Self-administered patient-centered questionnaires have been shown to be practical, reliable and valid in terms of evaluating functional limitations in rheumatic diseases. In systemic sclerosis a modified version of the HAQ and condition-specific questionnaires have been used. The Health Assessment Questionnaire (HAQ) ...

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    doi:10.1007/s003930070014

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    abstract::NSAIDs, including acetylsalicylic acid, are frequently classified as peripherally-acting analgesics. This is based on the fact that these substances, among other effects, inhibit the biosynthesis of prostaglandines. A few solid arguments, however, stand against an exclusively peripheral mode of the analgesic action of...

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    doi:

    authors: Jurna I

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  • [Diffuse interstitial lung diseases in association with connective tissue diseases].

    abstract::This article gives a comprehensive overview of diffuse interstitial lung diseases especially those associated with connective tissue diseases. Interstitial lung diseases (ILD) represent a heterogeneous group of diseases of very different and partially unknown etiologies. Therefore, an exact classification of the ILD i...

    journal_title:Zeitschrift fur Rheumatologie

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    doi:10.1007/s00393-003-0485-z

    authors: Koller HK,Burghuber OC

    更新日期:2003-04-01 00:00:00

  • [Correlations between irrational attitudes and pain quality in patients with chronic polyarthritis].

    abstract::The present study examined relations between irrational attitudes and pain experience in patients with rheumatoid arthritis (RA). 128 patients with definite RA from a rheumatic treatment center were studied by administration of the Irrational Attitudes Questionnaire (15) and a revised form of the Multidimensional Pain...

    journal_title:Zeitschrift fur Rheumatologie

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    doi:

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    更新日期:1990-05-01 00:00:00

  • [Biomarkers and personalized medicine].

    abstract::Biomarkers form the basis for patient stratification and the development of individualized treatment strategies. As the understanding of the pathophysiological processes underlying rheumatic diseases increases, novel biomarkers will become available and established markers can be used more efficiently. Autoantibodies ...

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    authors: Scherer HU,Burmester GR,Häupl T

    更新日期:2013-02-01 00:00:00

  • [Sex-specific differences of the immune system].

    abstract:BACKGROUND:Sex-specific differences in the prevalence and severity of immune disorders are well-known phenomena; however, it is only recently that we have begun to understand the possible causes of such differences. MATERIAL AND METHODS:A literature search on this topic was carried out and the results are summarized. ...

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    abstract::New strategies including the blockade of TNFalpha showed excellent therapeutic effects even in so far refractory rheumatic diseases. Moreover, these approaches provided us with important informations about the pathogenic role of the mediators involved and distinct autoimmune cellular subsets. Here, we discuss recent d...

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    更新日期:2003-08-01 00:00:00