Treatment for ANCA-Associated Vasculitis

Several medicines are used to treat ANCA-associated vasculitis. Treatment usually has 2 goals: first, to bring the disease under control, and then to keep it from coming back. Treatments work differently for each person, so your care team will build a plan around your needs.¹

How treatment works

Treatment is often described in 2 phases. The first phase gets active disease under control. The second phase, called maintenance, keeps the disease in remission, usually for at least 12 to 24 months. Your doctor decides how long you need treatment based on how you respond.¹

Medications for ANCA-associated vasculitis

There are several different types of medications that may be used to treat ANCA-associated vasculitis.

Glucocorticoids

Glucocorticoids, such as prednisone, are a standard part of treatment. They work quickly to reduce inflammation and are often used along with other medicines that calm the immune system. As the disease comes under control, doctors usually lower the dose slowly over time rather than stopping all at once.^1,2

Rituximab (Rituxan®)

Rituximab is a biologic medicine. The US Food and Drug Administration (FDA) approved it in 2011 to treat GPA and MPA, and it is used together with glucocorticoids. It is one of the main medicines used for severe disease.^2,3

Cyclophosphamide and other immunosuppressants

Cyclophosphamide is an immunosuppressant used to help bring severe disease under control, often as part of the first phase of treatment. For milder disease or to maintain remission, doctors may use other immune-slowing medicines such as methotrexate or azathioprine.^1,2

Avacopan (Tavneos®)

Avacopan is an oral medicine that the FDA approved in 2021. It is used as an add-on to standard therapy, including glucocorticoids, for adults with severe active ANCA-associated vasculitis. It helps reduce blood vessel inflammation, but it does not remove the need for glucocorticoids.²

In April 2026, the FDA's Center for Drug Evaluation and Research proposed withdrawing Tavneos from the market, saying new information indicates the drug has not been shown to be effective for its approved use. The agency also raised new safety concerns, including cases of serious liver injury. Tavneos remains available for now, and the FDA recommends that patients talk with their doctor about whether to start or continue it while a final decision is being made.⁴

Keeping the disease in remission

Once the disease is under control, you will likely keep taking maintenance medicines to lower the chance of a relapse. These may include azathioprine, methotrexate, or rituximab. Most people stay on maintenance treatment for at least 12 to 24 months.^1,3

Why staying on treatment matters

ANCA-associated vasculitis can come back, even after it improves. That is why most people keep taking maintenance medicines for at least 12 to 24 months to lower the chance of a relapse. Do not stop or change your medicines without talking to your doctor first, even if you feel better.^1,3

What are the possible side effects?

Side effects can vary depending on the specific treatment or drug you are taking. Because many of these medicines slow the immune system, they can raise the risk of infection.¹

These are not all the possible side effects of treatment for ANCA-associated vasculitis. Talk to your doctor about what to expect, and call your doctor if you have any changes that concern you during treatment.

Other things to know

Some treatments listed here are not approved by the FDA to treat ANCA-associated vasculitis. They may be approved for other conditions. A doctor may prescribe them “off-label” when evidence suggests they help. Talk to your doctor about what is right for you.

Before beginning treatment for ANCA-associated vasculitis, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs. Together, you and your care team can choose the plan that is right for you.