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Vasculitis and Connective Tissue Disease
Vasculitis and Connective Tissue Disease Management provides specialist rheumatology care for autoimmune vasculitic conditions using immunosuppression, biologics, and careful monitoring to achieve remission, prevent organ damage, and reduce treatment side effects.
Overview
Key Benefits
Discover the advantages of choosing our vasculitis and connective tissue disease services.
Rituximab induction achieves remission in 75 to 80% of severe ANCA-associated vasculitis
Early treatment prevents permanent organ damage from active vasculitis
Maintenance immunosuppression reduces 18-month relapse rate from 40 to 50% to below 15%
PJP prophylaxis prevents potentially fatal pneumocystis pneumonia in immunosuppressed patients
Structured steroid tapering minimises the cumulative steroid side effect burden
Clinical Features
The technology, techniques and clinical approach behind our vasculitis and connective tissue disease.
Structured prednisolone tapering protocol balances disease control and steroid side effect minimisation
Rituximab preferred over cyclophosphamide for its superior safety profile in ANCA-associated vasculitis
PJP prophylaxis prescribed for all patients on triple immunosuppression
DEXA bone density monitoring and prophylactic bone protection for all steroid-treated patients
Annual urinalysis monitors for cyclophosphamide-related bladder cancer
Preparation Instructions
Never reduce or stop corticosteroids or immunosuppressants without medical advice -- vasculitis relapses can be life-threatening. Carry your steroid card at all times. Report any fever or significant infection immediately as immunosuppression increases infection risk. If you have GCA, contact your rheumatology team or emergency services immediately for any sudden visual change, severe headache, jaw pain while eating, or scalp tenderness.
The Procedure
Step-by-step guide to what you can expect during your vasculitis and connective tissue disease procedure.
Disease Activity Assessment and ANCA Measurement
ANCA titres CRP ESR haemoglobin and kidney function are reviewed. Clinical disease activity scores (BVAS for AAV) quantify activity level. New or worsening symptoms are investigated before modifying therapy.
Corticosteroid Tapering Protocol
Prednisolone taper follows a structured protocol starting at 40 to 60 mg daily and reducing by 5 mg fortnightly to 15 mg then more slowly. Inadequate tapering risks flare. Bone protection is prescribed for all steroid-treated patients.
Rituximab or Cyclophosphamide Induction
Severe AAV requires rituximab IV or cyclophosphamide IV induction for 3 to 6 months alongside high-dose prednisolone. Rituximab is preferred due to superior B-cell depletion and lower bladder cancer risk.
Maintenance Immunosuppression
Following induction remission is maintained with azathioprine or low-dose rituximab. Maintenance prevents relapse which occurs in 30 to 50% without ongoing immunosuppression.
Infection Prophylaxis and Vaccination
PJP prophylaxis with co-trimoxazole is prescribed for all patients on triple immunosuppression. Annual flu vaccine pneumococcal vaccine and shingles vaccine are administered for eligible patients.
Long-Term Complication Monitoring
Cyclophosphamide-related bladder cancer risk requires annual urinalysis. DEXA bone density monitors steroid-induced osteoporosis. Blood pressure and renal function monitor for hypertension and permanent renal damage.
What to Expect
Your rheumatologist assesses disease activity using clinical examination, blood tests, urinalysis, and imaging. Corticosteroid tapering is guided by clinical response and inflammatory markers. Rituximab, tocilizumab, or targeted biologics are introduced when remission cannot be achieved with conventional therapy. Calcium, vitamin D, and bone protection are reviewed at every appointment.
Frequently Asked Questions
Common questions about vasculitis and connective tissue disease.
Related Services
Explore other services in our Rheumatology department.
Rheumatoid Arthritis Management
Osteoporosis Assessment and Treatment
Gout and Crystal Arthropathy
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.
