Monitoring

The Birmingham Vasculitis Activity Score (BVAS) has been validated for initial assessment, with a high BVAS at baseline predictive of a worse outcome.[19][56][107] The BVAS can be used to assess effectiveness of treatment over time. A flare of disease corresponds to a score above 0; remission is indicated by a score of 0.

A validated tool, such as the BVAS, or the Vasculitis Damage Index (VDI), are used to assess disease activity, the site and extent of involvement, and overall quality of life.[60]

Assessments should include clinical, laboratory, and investigations dependent on organ involvement.[60] Use of cyclophosphamide, azathioprine, and other immunosuppressive agents requires specific blood and urine monitoring as per standard protocols.[60] Repeat angiography is not routinely used in follow-up, because improvement in clinical features has been found to parallel the resolution of aneurysms.[20][114]

Female patients should have an annual cervical smear for 3 years after cyclophosphamide therapy.[60][115]

Yearly influenza vaccines are recommended.[113] Pneumococcal vaccine should be offered if antibody levels are low.[113] Live vaccines should not be used until 3 months after cyclophosphamide has been stopped.

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