New developments in treatments for systemic vasculitis.

The systemic vasculitides are rare autoimmune diseases with significant morbidity and mortality. These diseases have primarily been treated using glucocorticoids combined with other immunosuppressive medications. While successful for many patients, this strategy is associated with substantial adverse effects including glucocorticoid-related toxicity and infection. Recent clinical trials have identified glucocorticoid-sparing agents and alternative efficacious therapies. In this article, we discuss new developments in the treatment of giant cell arteritis and ANCA-associated vasculitis. Topics reviewed include the use of biologic agents for treating giant cell arteritis and polymyalgia rheumatica, as well as the use of plasma exchange and strategies to minimize glucocorticoid exposure in ANCA-associated vasculitis.