This protocol covers active granulomatosis with polyangiitis (GPA) in patients whose disease manifestations are neither organ-threatening nor life-threatening. Correctly identifying this subset is clinically significant: the treatment approach differs from severe or life-threatening presentations, and appropriate therapy selection depends on accurate disease severity assessment.
Induction of remission in non-organ-threatening, non-life-threatening GPA is built around a combination of glucocorticoids and a targeted immunosuppressive agent, with a structured, stepwise glucocorticoid reduction over the first several months. Alternative immunosuppressive agents may be considered for suitable patients.
The complete regimen — including agent selection, sequencing, maintenance strategy, infection prophylaxis, and duration — is available in the full protocol.
The primary aim is remission: the absence of typical signs, symptoms, or other features of active disease. The protocol is structured to sustain that remission across 24–48 months of maintenance therapy.