Curbside Consults Podcast

Published December 2, 2021

In this episode of Curbside Consults, we examine the latest guidelines on the management of ANCA-associated vasculitis by the American College of Rheumatology (ACR) and Vasculitis Foundation. In doing so, we review the major trials in vasculitis research published during the last 10 years with one of the guideline authors, Dr. Peter Merkel, Chief of the Division of Rheumatology at the University of Pennsylvania.

00:05 – Intro
00:48 – Review of ANCA-associated vasculitis
01:40 – Overview of guideline development
04:53 – Rituximab for induction therapy
07:40 – Plasma exchange (PLEX)
09:52 – Glucocorticoids
11:25 – TMP/SMX as prophylaxis and treatment
13:05 – EGPA: A shifting paradigm
15:07 – Avacopan: The new kid on the block
16:24 – Concluding remarks

Articles discussed in this episode:

1. Stone JH et al. Rituximab versus Cyclophosphamide for ANCA-Associated Vasculitis. N Engl J Med 2010.
2. Jones RB et al. Rituximab versus Cyclophosphamide in ANCA-Associated Renal Vasculitis. N Engl J Med 2010.
3. Walsh M et al. Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis. N Engl J Med 2020.
4. Wechsler ME et al. Mepolizumab or Placebo for Eosinophilic Granulomatosis with Polyangiitis. N Engl J Med 2017.
5. Jayne DR et al. Avacopan for the Treatment of ANCA-Associated Vasculitis. N Engl J Med. 2021.

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

Dr. Peter Merkel is Chief of the Division of Rheumatology at the University of Pennsylvania.
Clement is a 2021–2022 NEJM Editorial Fellow.