Treating vasculitis with conventional immunosuppressive agents.

Standard therapy for granulomatosis with polyangiitis and other vasculitides is a combination of cyclophosphamide and glucocorticoids. Although most patients achieve remission, relapses and treatment-related morbidities are common. Clinical trials have yielded a wealth of data about less toxic alternatives to standard therapy, including new agents and methods of delivery. All aim to reduce long-term exposure to cyclophosphamide and glucocorticoids and so maintain safety while effectively preventing relapse. Individualized evaluation of risk and treatment selection will help maximize effectiveness and minimize toxicity.