The recently published CHUSPAN 2 study addresses an important issue of the optimum treatment for nonsevere systemic necrotising vasculitis (SNV) that poses no immediate threat to life or essential organs function (1). This study was conducted by the French Vasculitis Study Group that contributed a lot to our understanding of systemic vasculitis. All SNVs have serious prognosis and require prompt immunosuppressive therapy. Nevertheless, it is clear today that less aggressive and less toxic immunosuppressive regimens (i.e. intravenous instead of oral cyclophosphamide for induction of remission, azathioprine with glucocorticoids in a lower dose for maintenance therapy, rituximab both for remission induction and maintenance) are appropriate for the majority of patients with SNVs. Current guidelines encompass mainly patients with more severe forms of granulomatosis with polyangiitis and microscopic polyangiitis leaving behind the scene patients with milder SNVs [2]. This article is protected by copyright. All rights reserved.
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Smitienko et al. (2017) studied this question.