Page 332 - The Vasculitides, Volume 1: General Considerations and Systemic Vasculitis

306 Elana J. Bernstein and Robert F. Spiera

patients showed a partial response after six months of treatment with rituximab. Twelve
months after therapy, 14 (82%) patients achieved sustained complete responses. Hellmann
and colleagues [43] reported two patients with RV-associated cutaneous ulcers refractory to
corticosteroids and disease modifying anti-rheumatic drug therapy that were successfully
treated with rituximab. Maher and Wilson [44] reported a patient with RV-associated foot
drop and sural nerve necrotizing vasculitis in who foot drop improved following multiple
courses of rituximab therapy.

Azathioprine

Azathioprine was shown to be effective for the treatment of RV in a randomized, double-
blind, placebo-controlled study of azathioprine in the treatment of RV in which there were no
differences between the azathioprine-treated and the placebo-treated groups at a mean
duration of 27 weeks of therapy [49]. Patients in both groups were permitted to remain on
their baseline corticosteroid dose, and there was no difference between the two groups in
mean corticosteroid dose. A randomized trial of prednisone plus azathioprine in eight patients
versus continuation of the existing therapeutic regimen in eleven all of whom were taking
non-steroidal anti-inflammatory drugs including one patient taking hydroxychloroquine, two
each aurothioglucose and penicillamine, and one sulfasalazine for the treatment of cutaneous
vasculitis, showed no difference in clinical or laboratory parameters between the two groups
at 18 months [50].

References

[1] Vollerstein RS, Conn DL, Ballard DJ, et al. Rheumatoid vasculitis: survival and risk
factors. Medicine (Baltimore) 1986; 65:365-375.

[2] Rasker JJ, Cosh JA. Cause and age at death in a prospective study of 100 patients with
rheumatoid arthritis. Ann. Rheum. Dis., 2982; 40:115-120.

[3] Pirano CL, Bennett GA. Rheumatoid arthritis; a report of three cases progressing from
childhood and emphasizing certain systemic manifestations. Bull Hosp. Joint. Dis.,
1951; 12:335-367.

[4] Sokoloff L, Wilens JL, Bunim JJ. Arteritis of striated muscle in rheumatoid arthritis.
Am J Path 1951; 27:157-173.

[5] Sokoloff L, Bunim JJ. Vascular lesions in rheumatoid arthritis. J. Chronic. Dis., 1957;
5:668-687.

[6] Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria.
Arthritis Rheum., 2010; 62:2569-2581.

[7] Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association
1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum.,
1988; 31:315-324.

[8] Jennette JC, Falk RJ, Bacon PA, et al. 2012 Revised International Chapel Hill
Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum., 2013; 65:1-11.

Complimentary Contributor Copy