A randomized controlled trial in patients 65 years of age and older shows that a “new and lighter treatment” plan was safer and more effective than conventional therapy in inducing remission in the systemic necrotizing vasculitides—a group of diseases that cause inflammation in various blood vessels. The new therapy involves corticosteroids for 9 months and a maximum of six 500-mg fixed-dose intravenous cyclophosphamide pulses, every 2–3 weeks, then maintenance azathioprine or methotrexate. Conventional treatment consists of 26 months of steroids, combined with 500 mg/m2 IV-CYC pulses, every 2–3 weeks until remission. Trial results published in Arthritis & Rheumatology found that the new therapy reduces severe adverse events, but three-year relapse rates remained high for both treatment groups.
http://onlinelibrary.wiley.com/doi/10.1002/art.39005/abstract
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