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AAV Maintenance Duration — SCE Rheumatology MCQ

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ModerateVasculitisAAV Maintenance DurationSCE Rheumatology

A 48-year-old man with GPA achieves remission with Rituximab induction. He is started on Rituximab maintenance 500 mg every 6 months. After 18 months his rheumatologist discusses the duration of maintenance therapy. According to BSR 2025 what is the recommended duration?

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Correct answer: C — 24-48 months of maintenance therapy

BSR 2025 AAV guidelines recommend maintenance immunosuppressive therapy for 24-48 months. The decision about the length of treatment should consider individual risk factors for relapse (PR3-ANCA positivity previous relapse upper respiratory tract involvement) and infection risk as well as patient preferences. Patients with renal-limited disease on dialysis may not need maintenance. After completing the maintenance period the decision to extend or stop should be individualised based on ANCA status disease history and patient factors.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions