The treatment of large-vessel vasculitis is drug-based, with the principles of controlling active lesions and relieving organ ischemia. Commonly used drugs include glucocorticoids such as prednisone, immunosuppressants such as cyclophosphamide, and biologics such as infliximab. Some patients need surgery according to their condition.
1. Drug treatment: active patients can use prednisone. Glucocorticosteroids alone are ineffective and can be combined with immunosuppressive agents, such as cyclophosphamide, azathioprine, methotrexate, mertiomacrophenol, and so on. TNF-α antagonists such as infliximab and IL-6 receptor monoclonal antibodies such as tolizumab have been reported to be effective.
2. Surgery: If the ischemia of important organs caused by vascular stenosis seriously affects the patient’s life, surgical treatment can be adopted, such as revascularization, stent implantation, etc.; if the lesion is extensive, open vascular bypass grafting can be carried out, etc.; if the severe renal artery stenosis causes intractable high blood pressure, nephrectomy can be considered.
It is recommended that patients with large-vessel vasculitis go to the hospital in time to avoid delay.