The rheumatologist of the Marqués de Valdecilla University Hospital in Santander and coordinator of the XIII Course on vasculitis of the Spanish Society of Rheumatology, Dr. Diana Prieto, has pointed out that "early diagnosis and prevention of relapses remain priority challenges" in the approach to vasculitis.
However, she has reminded that "In recent years, there have been great advances in the understanding of the mechanisms that cause vasculitis, which has allowed the identification of new therapeutic targets and the expansion of treatment options," as she stated during the meeting held in Murcia, which has had the collaboration of CSL and GSK.
Vasculitis encompasses a set of diseases in which inflammation occurs in the walls of blood vessels, which can alter blood flow and put the functioning of the involved organs and tissues at risk. These are very diverse pathologies that can present at any time in life, from childhood to very advanced ages, and that also significantly affect young people.
Types of vasculitis and classification
Although they can manifest at any age, certain subtypes of vasculitis are more common at specific periods of the life cycle. In childhood, Kawasaki disease and immunoglobulin A vasculitis, previously known as Schönlein-Henoch purpura, are more frequent. In contrast, giant cell arteritis is mainly observed in those over 50 years old, while Takayasu arteritis usually begins in younger individuals.
The classification of vasculitis is carried out, among other factors, based on the caliber of the affected blood vessels: large, medium, or small. Within this group are included, among others, granulomatosis with polyangiitis, microscopic polyangiitis, and Behçet's disease. This wide variety requires individualizing the diagnostic process, the choice of treatment, and the follow-up strategy according to the specific type of vasculitis.
Among the most recent therapeutic advances, the specialist highlights "biological therapies and targeted drugs, which allow for better disease control and reduce exposure to glucocorticoids, as well as advances in imaging techniques and the recent update of international recommendations for the classification and management of systemic vasculitis."
In his understanding, "although much progress has been made, there are still significant challenges such as achieving more personalized and safe treatments that control the disease without the side effects of classic immunosuppressants. It is important to continue working on improving diagnostic standardization and to detect relapses or complications early through biomarkers and more precise imaging techniques."
Furthermore, he considers it a priority to delve into the mechanisms involved in chronic vascular damage and in the complications that arise in the long term.
On the other hand, Dr. Patricia Moya, also coordinator of the course and rheumatologist at the Hospital Universitari de la Santa Creu i Sant Pau (Barcelona), emphasizes that "the diversity of vasculitis makes its diagnosis complex, especially when the first symptoms are nonspecific, such as fever, fatigue, or weight loss."
In addition, she stresses that the proper management of these diseases requires regular medical check-ups, even in phases of apparent stability. In this regard, she underscores that "adherence to treatment and communication with healthcare professionals are fundamental to detect possible changes in evolution and reduce the risk of complications."