The key to lessening the symptoms of the many types of vasculitis is to reduce inflammation. Anti-inflammatory medications, notably glucocorticoids such as prednisone or methylprednisolone, are the most common first-line treatments. Glucocorticoids are effective, but patients who take them over a long time period may experience side effects and toxicities.
Medications that suppress the body’s immune system, such as rituximab or cyclophosphamide, may also be used to reduce dosages of glucocorticoids and reduce the long-term risks associated with them. There are various types of medications that suppress the immune system and selection of the appropriate agent depends on the type of vasculitis, the severity of the disease, and the organ systems involved.
In general, the approach is to use a strong drug (for 3 to 6 months) to put the vasculitis in remission (where there is no sign of active disease) and then a more mild drug (over 12 to 36 months or longer) to maintain that remission and protect from flare ups of disease.
Immunosuppressants used to treat vasculitis include:
- Mycophenolate mofetil
- TNF inhibitors (infliximab, adalimumab, certilizomab or golimumab)
Plasmapheresis (Plasma Exchange)
In some severe cases, a patient’s plasma, which contains harmful antibodies, may be exchanged for healthy plasma through a procedure similar to dialysis.
When advanced forms of vasculitis cause significant damage to blood vessels, vascular bypass surgery may be performed to redirect the flow of blood around the damaged vessel. Surgery may also be required to repair or replace (via transplant) damaged or failed organs resulting from vasculitis.
Research at University of Michigan
While getting clinical care at Michigan Medicine Vasculitis Program you might have the opportunity to participate in research and contribute to advancing our understanding and options for treatment for these rare diseases.
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Online resources from the following organizations were cited for information on vasculitis types, symptoms, risk factors, diagnosis and treatment:
- The American College of Rheumatology
- The Arthritis Foundation
- The Vasculitis Foundation
- NIH Genetic and Rare Diseases Information Center
- Archives of Neurology (PubMed)