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ANCA Rise Without Clinical Relapse — SCE Rheumatology MCQ

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ModerateVasculitisANCA Rise Without Clinical RelapseSCE Rheumatology

A 50-year-old man with GPA has PR3-ANCA at 85 IU/mL (elevated). His disease is in clinical remission. Should treatment be changed based on ANCA titre alone?

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Correct answer: B — Do not change treatment on ANCA titre alone

BSR 2025: ANCA changes may predict relapse (particularly PR3-ANCA) but pre-emptive treatment based on ANCA alone is not routinely recommended. Increased surveillance (more frequent reviews urinalysis CRP) is appropriate. Treatment change only for clinical relapse.

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