Low Doses of Glucocorticoids Could be Useful for Older Patients With ANCA Vasculitis

According to a story from ANCA Vasculitis News, a recent study has found that a low-dose regimen of glucocorticoids that explicitly exclude the drug methyprednisolone can be a useful therapy for older patients with ANCA-associated vasculitis, a rare inflammatory disease. The original study can be found in the medical journal RheumatologyThe findings could have significant implications as many ANCA vasculitis patients are around 70 years or older.

About ANCA Vasculitis

ANCA vasculitis is a disease that is characterized by the damage and destruction of blood vessels as a result of inflammatory activity. The disease is associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCA). These are autoantibodies that target antigens present on neutrophils (the most common type of white blood cell) and monocytes. This means that the mechanism of the disease is autoimmune, in which the body’s own immune system mistakenly attacks healthy body tissue. Symptoms of ANCA vasculitis include kidney inflammation, fever, weight loss, abdominal pain, bloody stools, purpura, nose bleeds, muscle pain, arthritis, bloody cough, vision problems, headaches, stroke, heart attack, and high blood pressure. Treatment of the disease is primarily focused on controlling inflammation and suppressing immune system activity. Common medications include cyclophosphamide, rituximab, and prednisone. Antibiotics may be necessary in cases of infection. To learn more about ANCA vasculitis, click here.

Older Patients Left Out of Research

Despite the fact that this disease becomes more common as people age, there is actually only limited data available that focuses on older patients and they are consistently under-represented in clinical trials. However, it is clear that the elderly are more susceptible to serious side effects when using some of the more common immune system suppressing therapies.

About The Study

The study looked at a total of 83 ANCA vasculitis patients whose median age was 74 years. These patients continued to receive whatever treatment they had been using. Outcomes were generally pretty good for this group; 83 percent were alive two years after follow-up and at five years 75 percent were alive. Patients’ health condition was also assessed at the beginning of the study using a frailty score.

The study found that a worse frailty score, older age, and higher degree of inflammation increased a patient’s risk of death. Researchers also determined that intravenous methylprednisolone did not confer a significant benefit for patients that used it relative to other patients. Generally, a low-dose of glucocorticoids was an effective therapy for this patient group.


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