TY - JOUR
T1 - Towards precision medicine in ANCA-associated vasculitis
AU - van der Geest, Kornelis S M
AU - Brouwer, Elisabeth
AU - Sanders, Jan-Stephan
AU - Sandovici, Maria
AU - Bos, Nicolaas A
AU - Boots, Annemieke M H
AU - Abdulahad, Wayel H
AU - Stegeman, Coen A
AU - Kallenberg, Cees G M
AU - Heeringa, Peter
AU - Rutgers, Abraham
N1 - © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
PY - 2018/8
Y1 - 2018/8
N2 - ANCA-associated vasculitis (AAV) is characterized by inflammation and destruction of small and medium-sized vessels. Current management strategies for AAV have been validated in large groups of patients. However, recent insights indicate that distinct patient subsets may actually exist within AAV, thereby justifying the development of more personalized treatment strategies. In this review, we discuss current evidence for a better classification of AAV based on ANCA type. We describe how thus defined categories of AAV patients may differ in genetic background, clinical presentation, immune pathology, response to treatment and disease outcome. We also explore how these insights may provide a rationale for targeted treatments in different categories of AAV patients. Finally, we provide recommendations on how to further establish precision medicine in AAV.
AB - ANCA-associated vasculitis (AAV) is characterized by inflammation and destruction of small and medium-sized vessels. Current management strategies for AAV have been validated in large groups of patients. However, recent insights indicate that distinct patient subsets may actually exist within AAV, thereby justifying the development of more personalized treatment strategies. In this review, we discuss current evidence for a better classification of AAV based on ANCA type. We describe how thus defined categories of AAV patients may differ in genetic background, clinical presentation, immune pathology, response to treatment and disease outcome. We also explore how these insights may provide a rationale for targeted treatments in different categories of AAV patients. Finally, we provide recommendations on how to further establish precision medicine in AAV.
KW - disease subsets
KW - vasculitis
KW - ANCA
KW - precision medicine
KW - personalized medicine
KW - ANTIBODY-ASSOCIATED VASCULITIS
KW - ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODIES
KW - NEUTROPHIL EXTRACELLULAR TRAPS
KW - SMALL-VESSEL VASCULITIS
KW - NECROSIS-FACTOR-ALPHA
KW - WEGENERS-GRANULOMATOSIS
KW - T-CELLS
KW - TREATMENT RESISTANCE
KW - RENAL VASCULITIS
KW - EOSINOPHILIC GRANULOMATOSIS
U2 - 10.1093/rheumatology/kex367
DO - 10.1093/rheumatology/kex367
M3 - Review article
C2 - 29045715
VL - 57
SP - 1332
EP - 1339
JO - Rheumatology
JF - Rheumatology
SN - 1462-0324
IS - 8
ER -