How to treat vasculitis

Treatment options for vasculitis are significantly correlated with the site of involvement, and even for the same disease, the therapeutic agents and treatment options are not identical depending on the organ involved. Immunosuppressive therapy is commonly used, and the main treatment regimen is a combination of glucocorticoids and cytotoxic drugs or alone. The etiology of vasculitis is not fully understood and varies among vasculitic diseases. Deposition of immune complexes in the vessel wall is one of its causes. Therefore, in addition to symptomatic treatment, glucocorticoids and cyclophosphamide remain the main agents of treatment. The treatment of vasculitis can be divided into the acute phase of treatment and the chronic phase of treatment. The acute phase is the period of active lesions, where patients show progressive symptoms and increased blood sedimentation and elevated C-reactive protein. Glucocorticoids can be administered orally with prednisone, or intravenously with methylprednisolone drips. After symptoms improve, the dose can be gradually reduced and administered orally with a maintenance dose of prednisone, which can be gradually reduced according to the response to treatment until it is discontinued. Cytotoxic drugs, such as cyclophosphamide and methotrexate, may be added. They are usually given orally for a sustained period of time and then tapered off over a period of months. In patients requiring mechanical ventilation due to respiratory failure, cyclophosphamide can be given intravenously by drip. Surgical or interventional treatment, including angioplasty and vascular bypass, may be considered for patients in remission and chronic phase.