Cytoxan was originally approved as a cancer therapy to block cell growth. In ANCA vasculitis, it is believed to kill the immune cells (such as neutrophils) that cause the damaging inflammation. It has been shown to be effective at inducing remission in 90 percent of ANCA vasculitis patients, but can cause severe side effects especially if used long-term.
Glucocorticoids, such as prednisolone, act as an anti-inflammatory. By reducing inflammation, they can reduce the damage caused by the immune system. These are the most commonly used treatments for ANCA vasculitis and are often used in combination with other therapies to induce and maintain remission.
The U.S. Food and Drug Administration (FDA) has approved Nucala as an add-on to standard care for treating eosinophilic granulomatosis with polyangiitis (EGPA) and also approved an autoinjector and a pre-filled safety syringe as new methods to dose Nucala. This makes Nucala the first anti-IL5 biologic therapy to be licensed in the U.S. for at-home administration, allowing clinicians and patients to decide where they receive treatment.
Rituxan is an antibody or protein designed to block a specific target. By inhibiting a protein called CD20, Rituxan reduces the numbers of B-cells. B-cells are a type of immune cells that are involved in producing ANCA, the trigger for the immune system to start attacking the blood vessels.