Abstract
The recent development of biologic therapies capable of selectively targeting components of the immune system has revolutionized the treatment of infl ammatory arthritides. The increase in the use of biologic agents coupled with expansion in the knowledge of the pathogenesis of vascular infl ammation has led to their application in the treatment of primary systemic vasculitis. Biological therapies appear to have a place in the therapeutic strategy for ANCA-associated systemic vasculitides, at least for patients whose disease is refractory to conventional therapy. The use of biologics as targeted therapies has also, in reverse, improved our understanding of the pathophysiology of vascular infl ammation. However, the precise indications for TNF-alpha inhibitors or anti-CD20 monoclonal antibodies have not yet been defi ned. These biologics must be prescribed extremely cautiously and only in trial settings, especially in view of the adverse effects. (*English Translation of J Jpn Coll Angiol, 2009, 49: 75-79)
