Vasculitis Program

Vasculitis: Personalized and Disease Specific Care

The Vasculitis Program, within the Rheumatology Unit at Massachusetts General Hospital provides individualized, cutting-edge care to patients with various forms of vasculitis. Our team of experts is dedicated to providing patients the most advanced care through personalized and comprehensive diagnosis and vasculitis treatment. We also lead innovative research in vasculitis and related conditions to improve outcomes for patients.

Vasculitis can affect blood vessels of different sizes, from small to medium to large. Our rheumatology providers in the Vasculitis Program have expertise in all forms of vasculitis, including but not limited to:

• Giant Cell Arteritis (GCA) or temporal arteritis
• Large Vessel Vasculitis
• Takayasu Arteritis
• Behcet’s Disease
• Cogan’s Syndrome
• Polyarteritis Nodosa (PAN)
• ANCA-associated vasculitis
  
  • Granulomatosis with Polyangiitis (GPA, previously known as Wegener’s granulomatosis)
  • Microscopic Polyangiitis (MPA)
  • Eosinophilic Granulomatosis with Polyangiitis (EGPA, also known as Churg-Straus Syndrome) 
• IgA Vasculitis (Henoch-Schonlein Purpura, HSP)
• Cryoglobulinemic Vasculitis
• Cutaneous vasculitis
• Primary angiitis of the central nervous system (PACNS)
• Clinically isolated aortitis

Our experts aim to establish prompt diagnosis and implement early treatment plans that can induce remission and prevent relapse of vasculitis in the long term. To maximize the effectiveness of vasculitis treatment and to minimize medication side effects, our approach relies on developing a personalized treatment plan for each patient.

Our comprehensive treatment approach brings close collaboration with specialists who have extensive experience in diagnosing and treating manifestations of vasculitis in different organs, including:

• Nephrologists
• Ear, nose and throat (ENT) specialists
• Neurologists
• Ophthalmologists and neuro-ophthalmologists
• Dermatologists
• Pulmonologists
• Cardiologists
• Gastroenterologists
• Infectious disease specialists
• Surgeons

What to Expect

The care of patients with vasculitis requires expertise and careful attention to details of the disease course. Therefore, we will perform a careful review of symptoms and any prior testing, including review of radiographic studies and biopsies with our radiologists and pathologists, as necessary.

Our experts invest time in educating patients about their conditions and determining an individualized treatment plan that considers patients’ values and preferences.

Our Research

Browse open clinical trials

Our experts are advancing the field of vasculitis through innovative studies in ANCA-associated vasculitis, Giant Cell Arteritis, glucocorticoid toxicity, and other conditions. We perform a wide variety of research, including clinical trials, observational, and translational studies to discover new approaches to diagnosing and managing vasculitis.

We are actively enrolling patients in the following research studies:

• Prospective Registry for ANCA-Associated Vasculitis: This study involves surveys every six months and a blood draw at one or more time points. For more information, contact: aavresearch@mgh.harvard.edu 
• Subclinical Atherosclerosis in ANCA-Associated Vasculitis (SAVe): This study involves a one-time CT scan of the coronary arteries to evaluate for heart disease. For more information, contact: aavresearch@mgh.harvard.edu
• Guselkumab for the treatment of Giant Cell Arteritis (ClinicalTrials.gov Identifier: NCT04633447).
• Secukinumab for the treatment of Giant Cell Arteritis (ClinicalTrials.gov Identifier: NCT04930094)

Our Team

• Sebastian Unizony, MD (Co-Director) 
• Zach Wallace, MD, MSc (Co-Director) 
• Eli Miloslavsky, MD
• John Stone, MD, MPH
• Cory Perugino, DO
• Mark Matza, MD, MBA
• Naomi Patel, MD

Selected Publications

• Cid MC, Unizony SH, Blockmans D, Brouwer E, Dagna L, Dasgupta B, Hellmich B, Molloy E, Salvarani C, Trapnell BC, Warrington KJ, Wicks I, Samant M, Zhou T, Pupim L, Paolini JF; KPL-301-C001 Investigators. Efficacy and safety of mavrilimumab in giant cell arteritis: a phase 2, randomised, double-blind, placebo-controlled trial. Ann Rheum Dis. 2022 May;81(5):653-661. doi: 10.1136/annrheumdis-2021-221865. Epub 2022 Mar 9. PMID: 35264321 Free PMC article. Clinical Trial.
• Scolnik, M; Fernández-Ávila, DG; Sato Inoue, E; de Souza, AWS; Magri, S; Saldarriaga-Rivera, LM; Ugarte-Gil, MF; Flores-Suarez, LF; Babini, A; Zamora NV; Acosta-Felquer, ML; Vergara, F; Carlevaris, L; Scarafia, S; Brance, ML; Soriano Guppy, ER; and Unizony, S. Pan American League of Associations for Rheumatology (PANLAR) Guidelines for the Treatment of Giant Cell Arteritis. Lancet Rheum. Volume 4, Issue 12, December 2022, Pages e864-e872
• Unizony SH, Bao M, Han J, Luder Y, Pavlov A, Stone JH. Treatment failure in giant cell arteritis. Ann Rheum Dis. 2021 Nov;80(11):1467-1474. doi: 10.1136/annrheumdis-2021-220347. Epub 2021 May 28. PMID: 34049857 Free PMC article. Clinical Trial.
• Stone JH, Tuckwell K, Dimonaco S, Klearman M, Aringer M, Blockmans D, Brouwer E, Cid MC, Dasgupta B, Rech J, Salvarani C, Schett G, Schulze-Koops H, Spiera R, Unizony SH, Collinson N. Trial of Tocilizumab in Giant-Cell Arteritis. N Engl J Med. 2017 Jul 27;377(4):317-328. doi: 10.1056/NEJMoa1613849. PMID: 28745999 Clinical Trial.
• Miyabe C, Miyabe Y, Strle K, Kim ND, Stone JH, Luster AD, Unizony S.An expanded population of pathogenic regulatory T cells in giant cell arteritis is abrogated by IL-6 blockade therapy. Ann Rheum Dis. 2017 May;76(5):898-905. doi: 10.1136/annrheumdis-2016-210070. Epub 2016 Dec 7. PMID: 27927642 Free PMC article.
• Wallace ZS, Miloslavsky EM. Management of ANCA associated vasculitis. British Medical Journal 2020 Mar 18;368:m421
• Miloslavsky EM, Niles JL, Wallace ZS et al. Reducing glucocorticoid duration in ANCA-associated vasculitis: A pilot trial. Seminars in Arthritis and Rheumatism 2018 Oct;48(2):288-292.
• Miloslavsky EM, Naden, RP, Bijlsma JW, et al. Development of a Glucocorticoid Toxicity Index (GTI) Using Multi-Criteria Decision Analysis. Annals of the Rheumatic Diseases 2017 Mar;76(3):543-546.
• Miloslavsky EM, Specks U, Merkel PA et al. Clinical outcomes of remission induction therapy for severe antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatology. 2013 Sep;65(9):2441-9
• McDermott GC, Fu X, Cook C, Ahola C, Doliner B, Hanberg J, Stone JH, Choi HK, Zhang Y, Wallace ZS. The effect of achieving serologic remission on subsequent risk of relapse, end-stage renal disease, and mortality in ANCA-associated vasculitis: A target trial emulation study. Ann Rheum Dis. 2022 (In Press) [https://pubmed.ncbi.nlm.nih.gov/35699465/]
• Doliner B, Rodriguez K, Montesi SB, Fu X, Sharma A, Wallace ZS. Interstitial lung disease in ANCA-associated vasculitis: Associated factors, radiographic features, and mortality. Rheumatology. 2022 (In Press) [https://pubmed.ncbi.nlm.nih.gov/35697489/]
• Wallace ZS, Cook C, Finkelstein-Fox L, Fu X, Castelino C, Choi HK, Perugino C, Stone JH, Park ER, Hall DL. The Association of Illness-Related Uncertainty with Mental Health in Systemic Autoimmune Rheumatic Diseases. J Rheum. 2022 (In Press) [https://pubmed.ncbi.nlm.nih.gov/35365580/]
• Wallace ZS, Wallwork R, Zhang Y, Lu N, Cortazar F, Niles J, Heher E, Stone J, Choi H. Improved Survival with Renal Transplantation for End-Stage Renal Disease due to Granulomatosis with Polyangiitis: Data from the United States Renal Data System. Ann Rheum Dis. 2018 Sep;77(9):1333-1338. [https://pubmed.ncbi.nlm.nih.gov/29760156/]
• McDermott G, Fu X, Stone JH, Wallwork R, Zhang Y, Choi HK, Wallace ZS. The Association Between Cigarette Smoking and ANCA-Associated Vasculitis: A Case-Control Study. JAMA Internal Medicine. 2020;180;870 [https://pubmed.ncbi.nlm.nih.gov/32282021/]