Therapeutic Objective
- Risk reduction or prevention of complications.
Therapy recommendations
- Therapy of bronchial asthma – see there!
- Therapy is based on the number of eosinophils (should be less than 700/ml).
- Cortisone therapy alone is indicated in the absence of cardiac involvement or severe inflammation of the peripheral nervous system.
- In case of manifestation in the heart, kidneys, CNS use of immunosuppressants.
Further notes
- Remission induction:
- Non-organ-threatening ANCA-associated vasculitis (AAV): glucocorticoids (GC, weekly 0.3 mg/kg bw) + methotrexate (MTX, max 25 mg/wk).
- Organ threat: GC + cyclophosphamide.
- Remission maintenance (therapy for at least 24 months):
- MTX or azathioprine (AZA) equivalentIn case of contraindications, intolerances, or previous treatment failure: rituximab (500 mg i.v. every 6 mo), plus GC ≤ 7.5 mg/d if necessary.
- Recurrence treatment:
- Recurrence with organ-threatening manifestation: renewed induction therapy with cyclophosphamide or rituximab, each plus GC (1 mg/kg bw, max 80 mg/d).
- Supportive therapy: treatment of comorbidities; vaccinations; tumor screening. Furthermore, treatment of cardiovascular risk factors / diseases.
