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Systemic vasculitis: one year in review 2026

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14

 

  1. Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; and Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy. chiara.marvisi@gmail.com
  2. School of Medicine and Surgery, University of Milano Bicocca, Milan; and Rheumatology Unit, Fondazione IRCSS San Gerardo dei Tintori, Monza, Italy.
  3. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa; and Department of Medical Biotechnologies, University of Siena, Italy.
  4. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
  5. IRCCS Istituto Auxologico Italiano, Unit of Immunology, Allergology and Rheumatology, Milan; and Department of Clinical Sciences and Community Health, University of Milan, Italy.
  6. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
  7. Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; and University of Modena and Reggio Emilia, Modena, Italy.
  8. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
  9. Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; and Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
  10. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
  11. Rheumatology Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
  12. Division of Rheumatology, Department of Medicine (DMED), Academic Hospital Santa Maria della Misericordia, ASUFC, University of Udine, Italy.
  13. Division of Rheumatology, Department of Medicine (DMED), Academic Hospital Santa Maria della Misericordia, ASUFC, University of Udine, Italy.
  14. Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; and University of Modena and Reggio Emilia, Modena, Italy.

CER19852
Review

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Received: 27/02/2026
Accepted : 17/03/2026
In Press: 27/03/2026

Abstract

Systemic vasculitides are rare, heterogeneous inflammatory diseases associated with significant morbidity due to vascular and end-organ damage. In 2025, major advances have refined pathogenic insights and therapeutic strategies across large-vessel vasculitis (LVV), ANCA-associated vasculitis (AAV), single-organ vasculitis, and cryoglobulinemic vasculitis (CV). Multi-omics and spatial transcriptomic approaches, imaging, and serological biomarkers are informing prognosis and management. Glucocorticoid minimisation remains a unifying therapeutic goal. Targeted therapies such as JAK inhibitors, avacopan and anti-IL-5/IL-5R agents have demonstrated efficacy and steroid-sparing effects in both trials and real-world studies. Together, these advances mark a transition toward precision, phenotype-driven management in systemic vasculitis.

Rheumatology Article