Clinical Rheumatology

, Volume 37, Issue 7, pp 2011–2012 | Cite as

Letter to the Editor: Time for cost-effectiveness studies for preventive strategies applied according to risk of cytomegalovirus-related morbidity and mortality in ANCA-associated vasculitis

  • Cynthia C. Lim
  • Irene Y. J. Mok
  • Jason C. J. Choo
Letter to the Editor


Gastrointestinal cytomegalovirus (CMV) disease in ANCA-associated vasculitis is associated with significant morbidity. Studies should be performed to identify the epidemiology and risk factors for CMV disease in AAV so that vulnerable patients may be risk-stratified for consideration of preventive strategies such as surveillance and pre-emptive therapy or anti-viral prophylaxis. Given the absence of evidence-based guidelines for prevention of CMV disease in patients with AAV receiving potent immunosuppressive therapy, further risk-benefit studies are required to ascertain if preventive strategies will reduce CMV-related morbidity and mortality in individuals with AAV.


Cyclophosphamide Immunosuppressive agents Methylprednisolone Prophylaxis 


Compliance with ethical standards


Jason Choo has served on Advisory Boards for Novartis and Pfizer with donation of honorarium to Singapore General Hospital to support research and education.


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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  1. 1.Department of Renal MedicineSingapore General HospitalSingaporeSingapore

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