GPA بدون مرض مهدد للأعضاء — ماذا تفعل عندما لم ينجح علاج الهدوء الأولي

DOI: 10.1136/ard-2022-223764

• For induction of remission of non-organ-threatening or non-life-threatening GPA or MPA, treatment with a combination of glucocorticoids and rituximab is recommended.
• Methotrexate or mycophenolate mofetil can be considered as alternatives to rituximab.
• For patients with GPA or MPA with disease refractory to therapy to induce remission, we recommend a thorough reassessment of disease status and comorbidities and consideration of options for additional or different treatment.
• It may be considered for remission induction in non-organ-threatening disease when the alternatives RTX, MTX and MMF cannot be used or are ineffective.
• Adding intravenous immunoglobulins can be an option for persistent disease manifestations, particularly in patients with increased risk of infection.
• These patients should be managed in close conjunction with, or referred to, a centre with expertise in vasculitis.
• Remission: Absence of typical signs, symptoms, or other features of active AAV with or without immunosuppressive therapy.