Update on the European Vasculitis Study Group trials

Over the last fifteen years, collaborative vasculitis studies in Europe hav e established the association of antineutrophil cytoplasmic antibodies (ANC A) with vasculitis and defined its clinical role as a diagnostic tool. More recently, the European Vasculitis Study Group has developed a consensus ap proach to the treatment of vasculitis and has aimed to harmonize and optimi ze current therapy by a series of multicenter randomized controlled trials. The first trial to report, CYClophosphamide or AZathioprine As a REMission therapy for vasculitis (CYCAZAREM), demonstrated that, for generalized vas culitis, azathioprine is as effective as continued cyclophosphamide for the maintenance of remission. Other trials are investigating the roles of meth otrexate, plasma exchange, and pulse cyclophosphamide in acute disease, and strategies to prevent relapse over the longer term. Parallel studies are d etermining prognostic markers, evaluating tools for monitoring disease, and examining the association of ANCA and infection with relapse. The establis hed infrastructure and accumulated database are well placed to facilitate t esting of newer therapeutic strategies in the future. Curr Opin Rheumatol 2 001, 13:48-55 (C) 2001 Lippincott Williams & Wilkins, Inc.