The British Society for Rheumatology management recommendations for ANCA-associated vasculitis (2025)
Summary. ANCA-associated vasculitides (AAV) represent a group of systemic autoimmune diseases characterized by necrotizing inflammation of small and medium-sized blood vessels and may lead to severe organ damage, particularly involving the kidneys, lungs, and peripheral nervous system. The main clinical entities include granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. In 2025, the British Society for Rheumatology (BSR) published updated clinical guidelines for the management of patients with ANCA-associated vasculitis based on contemporary evidence and results from recent randomized controlled trials. The document outlines current approaches to remission induction and maintenance therapy, the use of glucocorticoids, rituximab, cyclophosphamide, and other immunosuppressive agents, as well as emerging strategies aimed at reducing treatment-related toxicity. The guidelines also address disease severity stratification, definitions of disease activity, prevention of complications, and the importance of multidisciplinary management in patients with AAV. The aim of this article is to summarize the key aspects of the 2025 BSR guidelines and to compare them with recommendations from other international professional organizations, including the European Alliance of Associations for Rheumatology (EULAR), the American College of Rheumatology (ACR), and Kidney Disease: Improving Global Outcomes (KDIGO).
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