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09-10-2017 | Vasculitis | Review | Article

Current and Future Treatment Options for Eosinophilic Granulomatosis With Polyangiitis

Current Treatment Options in Rheumatology

Authors: MD Alvise Berti, MD Ulrich Specks, MD Karina A. Keogh, MD, PhD Divi Cornec

Publisher: Springer International Publishing


Purpose of review This review aims to give an overview of efficacy and safety of the therapeutic options for eosinophilic granulomatosis with polyangiitis (EGPA).
Recent findings There are few current treatments beyond glucocorticoids for the successful induction and maintenance of remission in EGPA, and glucocorticoids remain the cornerstone of treatment. Life-threatening manifestations likely benefit from the addition of cytotoxic agents, although results of studies investigating cyclophosphamide or azathioprine have shown mixed efficacy results and high adverse event rates. More recently, targeted therapies including rituximab and mepolizumab have shown encouraging results. Since bronchial asthma often persists beyond the control of vasculitis disease manifestations, inhaled respiratory therapy and a multispecialty management approach are advocated.
Summary EGPA has been the subject of very few randomized controlled trials. Glucocorticoids remain the cornerstone of treatment. Among others, evidence of efficacy for mepolizumab and rituximab is accumulating. The optimization of asthma control is recommended.

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