Evidencias sobre la eficacia de los tratamientos biológicos en las vasculitis sistémicas

In recent decades, there has been a breakthrough in the treatment of systemic vasculitis, although substantial morbidity and mortality are still associated with these diseases, often related to immunosuppressive therapy. The success of biologic therapy in rheumatoid arthritis and other autoimmune diseases has led to research into these agents in systemic vasculitis. Anti-tumor necrosis factor (TNF) agents have proven useful in the treatment of Takayasu arteritis refractory to conventional treatment but there is no evidence of their effectiveness in other types of vasculitis. Anti-CD20 therapy (rituximab) has proven effective in ANCA vasculitis refractory to cyclophosphamide. Two recently published clinical trials have shown that rituximab is not inferior to cyclophosphamide as induction therapy of remission in ANCA Vasculitis, so in the future, could be considered a first line treatment in these patients.