What research is needed to better diagnose or treat autoimmune vasculitides?
A growing area of interest and future research includes the use of biological drugs that may target more specifically the disputed pathways in some of these disorders. It is highly encouraged that stroke be incorporated as an independent outcome in future trials. Steroids are often used to treat autoimmune vasculitis. This may be problematic in people with coexisting vascular risk such as hypertension and diabetes. Further research is needed on the safety profile of long-term steroids and steroid-sparing agents in stroke populations. Similarly, the timing of steroid initiation and post-steroid biopsy yield should be further delineated. In adults with ischemic stroke or TIA and symptoms of giant cell arteritis, the benefit of an initial high-dose intravenous pulse of steroids versus oral steroids in stroke prevention is uncertain. For the treatment of VZV vasculitis, the role of steroids as adjunctive therapy to acyclovir is not well established.