Getting off Immunosuppressants Can Help ANCA Vasculitis Patients Avoid Relapse, Study Suggests

According to a publication from ANCA Vasculitis News, a new study in International Kidney Reports suggests that stopping treatment of the disease once it goes into remission may lead to better health outcomes for ANCA patients.

About ANCA Vasculitis

ANCA vasculitis, also known as ANCA-associated vasculitis, is an autoimmune disease that causes the inflammation and swelling of small blood vessels throughout the body.

ANCA vasculitis is caused by the presence of the autoantibody from which the name of the condition is derived – anti-neutrophilic cytoplasmic autoantibodies. These antibodies are not found in healthy individuals. ANCAs target the cytoplasm (think of it as the jelly inside most cells) of neutrophils – immune white blood cells that fight infection (making up half or a majority of all white blood cells).

When an ANCA targets and attacks a neutrophil, it latches onto the white blood cell and takes control. The infected neutrophil then starts to attack the walls of the blood vessels, causing the inflammation and swelling that characterizes the condition.

Other symptoms of ANCA vasculitis are extensive and varied. ANCA vasculitis can affect several different areas of the body, and will present with different symptoms depending on where it is present. The eyes, lungs, sinuses, nerves, and even skin can all be affected, and all be affected differently. However, general discomfort, often serious bleeding, and diminished function of the affected organ are commonly observed in most areas ANCA vasculitis can occur.

Stopping Treatment for Better Outcomes

Treating an autoimmune disease like ANCA vasculitis can be especially challenging because the standard treatment is immunosuppressant therapy. Immunosuppressants are a class of drug that work to inhibit the effectiveness of the immune system – important when managing an already overactive system.

However, while it’s important to limit autoimmune response in ANCA vasculitis patients, prolonged exposure to immunosuppressants can leave patients especially vulnerable to certain cancers and infection. Finding a way to limit the immune response while not overly weakening the system is a delicate, high-tech balancing act.

The new study, conducted by a team of Americans, examined 427 individuals with ANCA vasculitis. Data collected by the team suggests that gender and the presence of an enzyme called proteinase 3 both play a role in reducing relapse rates.

Impressively, patients who stopped immunosuppressant therapy while their ANCA vasculitis was in remission experienced a 49% lower risk of relapse compared to their peers who continued treatment. However, the “underlying mechanism,” behind the reduction is still unknown.

As long as the autoimmune disease is treated early and aggressively when there are flare-ups, temporarily halting treatment while the condition is dormant could lead to better quality of life for ANCA patients.

Do you think enough thought is put into life without medication? Do you think medication has been so effective that there is a disincentive to ever “going off” meds? Share your thoughts with Patient Worthy!

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