Treatments and drugs

By Mayo Clinic Staff

Your treatment will be focused on controlling the inflammation with medications and resolving any underlying disease that triggered your vasculitis. For your vasculitis, you may go through two treatment phases — stopping the inflammation and preventing relapse (maintenance therapy).

Both phases involve prescription drugs. Which drugs and how long you need to take them depend on the type of vasculitis, the organs involved and how serious your condition is.

Some people have initial success with treatment, then experience flare-ups later. Others may never see their vasculitis completely go away and need ongoing treatment.

Medications used to treat vasculitis include:

  • Corticosteroids to control inflammation. Your doctor may prescribe a corticosteroid drug, such as prednisone or methylprednisolone (Medrol). These help control inflammation in the affected blood vessels. Side effects of corticosteroids can be severe, especially if you take them for a long time. Possible side effects include weight gain, diabetes and bone thinning (osteoporosis). If a corticosteroid is needed for long-term (maintenance) therapy, you'll likely receive the lowest dose possible.
  • Medications to affect the immune system. If you don't respond to corticosteroids, your doctor may prescribe cytotoxic or immunosuppressant drugs. These types of drugs kill or decrease the function of immune system cells causing the inflammation. They include azathioprine (Azasan, Imuran), methotrexate (Trexall, Rheumatrex) and cyclophosphamide. Possible side effects of cyclophosphamide include increased risk of cancer, infertility and infection. So even though this drug is effective in controlling inflammation, it isn't always the first choice, especially for long-term therapy.

    Rituximab (Rituxan) is a safe and effective option for treating some types of vasculitis. Rituximab has proved to be a good option for maintenance therapy, unless you have had hepatitis B. A side effect of rituximab is an increased risk of reactivating hepatitis B.

Oct. 08, 2014