Healthcare providers use various medications to treatvasculitis, a sometimes severe condition that may cause organ damage or death.
This article describes some primary treatment considerations when picking short- and long-term medications for vasculitis.
Clinicians generally want to use the lowest doses of the safest drug possible while controlling symptoms.
Illustration by Michela Buttignol for Verywell Health
Some important considerations in vasculitis treatment are treatment phase, severity, and pop in.
Treatment Phase
Healthcare providers often think about treating vasculitis in two phases.
The goal of the initial treatment phase is to get symptoms under control.
This is followed by a maintenance phase, which aims to keep symptoms from returning.
But if your symptoms return, treatment might need to be increased again.
Vasculitis Severity
The severity of your vasculitis also heavily impacts the treatment approach.
You may need stronger medications or medication combinations if you have severe symptoms.
Treatment with a less intense medication (or combination of drugs) may be sufficient for more mild disease.
Although they share some underlying similarities, different medications work better for some types of vasculitis compared to others.
Because of this, healthcare providers recommend different treatment approaches for different vasculitis types.
Corticosteroids
A group of drugs calledcorticosteroidsare a mainstay of treatment for all types of vasculitis.
They are essential to get the disease under control during initial treatment.
In general, corticosteroids tone down the overactive immune response andinflammationof the blood vessels found in vasculitis.
Usually, you use them in addition to immunosuppressive therapy.
This gets the drug into your system as quickly as possible.
Corticosteroids are often dropped during the maintenance phase.
But in some cases, you might continue to use them in much lower doses.
Older Immunosuppressive Therapies
Practitioners sometimes use several older, oral pharmaceuticalimmunosuppressive drugsto treat vasculitis.
Although they all work slightly differently, the overall effect is to tamp down the overactive immune response.
Some are also used in otherautoimmune conditions.
Some of these drugs are commonly prescribed to people with mild vasculitis or who are in remission.
Later, during the maintenance phase, they might take methotrexate without a glucocorticoid.
However, these older immunosuppressives sometimes benefit people with a severe form of the disease.
An important example isCytoxan (cyclophosphamide).
Newer Biologic Immunosuppressive Therapies
A variety of newer therapies are sometimes used to treat vasculitis.
Unlike the previous examples, they need to be taken into your veins or as an injection.
Many of these biologics are prescribed for other autoimmune conditions, and some also treat cancer.
Rituxan is also an important example.
Then, you might continue to take Rituxan during the maintenance phase but without the corticosteroids.
Other Medications
Additional medications may be needed to treat vasculitis in specific situations.
How Long Are Patients on Vasculitis Medications?
Physicians and scientists debate how long people should stay on these treatments.
It can vary, but you might remain on your initial vasculitis treatments for three to six months.
After that, your therapy might be stepped down during a maintenance phase.
In some cases, you might switch to a generally safer drug, such as from cyclophosphamide to methotrexate.
Scientists arent yet sure how long people should stay in this maintenance phase.
When taking immunosuppressive medications, you are more susceptible to infections you might not otherwise get.
Theres also a greater risk that such an infection would be severe.
Risks of Cancer
Some therapies also may slightly increase your risk of developing certain kinds of cancer.
However, this varies significantly among the different treatments, and healthcare providers often dont have reasonable estimates.
Possible side effects include:
Steroids are important and sometimes lifesaving treatments.
Some common side effects are diarrhea, nausea, mild hair loss, rash, fatigue, or headache.
It requires receiving several types of antibodies through a vein.
It doesnt come with the same risk of infection as other treatments.
Its most often prescribed to people with a disease thats challenging to treat.
Over-the-Counter Vasculitis Medications
Most medications needed to treat vasculitis are available only with a prescription.
Examples includeAdvil (ibuprofen), Aleve (naproxen sodium), orTylenol (acetaminophen).
Summary
Most vasculitis treatments target the immune system and tone down the overactive response causing the disease.
Corticosteroids, older drug immunosuppressants, and newer biologic immunosuppressants are the mainstays of treatment.
Often, youd start out using a corticosteroid in addition to one of these other therapies.
Increased risk of other infections is one of these drugs most important potential side effects.
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