Wegener's Granulomatosis (cont.)
How is Wegener's granulomatosis treated?
Wegener's granulomatosis is a serious disease and without
treatment can
be fatal within months. Treatment is directed toward stopping
the
inflammation process by suppressing the immune system.
Medications used to
treat Wegener's granulomatosis include high-dose cortisone
(prednisone)
and the immunosuppressive drug cyclophosphamide
(Cytoxan). Recent reports also suggest that trimethoprim/sulfamethoxazole (Bactrim) can
also be
helpful to prevent relapse of disease activity in patients with
Wegener's granulomatosis.
Cytoxan that is taken by mouth with prednisone until the disease is in remission and then switched to methotrexate for
two years and tapered off has been reported to be effective and less toxic than the traditional long-term Cytoxan treatment.
Methotrexate has recently been introduced as a drug for Cytoxan treatment failures. Moreover, it now appears that Cytoxan will not be necessary in order to maintain long-term remission and that doctors can convert to the less toxic methotrexate for maintenance. The reports also demonstrate that methotrexate can eventually be tapered off entirely after
two years. Azathioprine (Imuran) has also been used as a maintenance medication after Cytoxan. Recently, intravenous immunoglobulin therapy (IVIG) has been shown to be helpful in treating relapses of Wegener's granulomatosis. Also, preliminary studies suggest that rituximab (Rituxan) may be helpful to maintain remission once the initial inflammatory disease has been controlled using medications mentioned above. These new regimens are welcome news for patients with Wegener's granulomatosis as medical researchers are searching for better treatments.
- Wegener's granulomatosis is an uncommon disease that
involves inflammation of blood vessels (vasculitis).
- Symptoms of Wegener's granulomatosis include fatigue,
weight loss, fevers, shortness of breath, bloody sputum, joint pains, and
sinus inflammation.
- Diagnosis of Wegener's granulomatosis is confirmed by
detecting both abnormal cellular formations, called granulomas, and
vasculitis.
- Treatment is directed toward stopping the inflammation
process by
suppressing the immune system.
References:
Clinical Primer of Rheumatology, Lippincott Williams & Wilkens, edited by William Koopman, et al., 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
American College of Rheumatology National Meeting, November 2005, 2006, 2007.
Last Editorial Review: 2/14/2008
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