How is large vessel vasculitis treated?

Updated: Dec 10, 2018
  • Author: Nadia Jennifer Chiara Luca, MD; Chief Editor: Lawrence K Jung, MD  more...
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A paucity of large controlled trials in the management of large-vessel vasculitis is noted, even in adult patients. Treatment recommendations are based on the EUVAS guidelines. [36]

Induction therapy usually involves high-dose glucocorticoid (prednisone, 1 mg/kg/d). The initial high dose should be maintained for a month and then gradually tapered. Azathioprine or methotrexate have been used as adjuncts to steroid therapy in patients with Takayasu arteritis to improve disease control and to facilitate reduction of the steroid dose. Cyclophosphamide has been used in adults with Takayasu arteritis resistant to glucocorticoids. In addition, tumor necrosis factor (TNF)-α inhibitors (eg, infliximab, etanercept) have been tried with encouraging results, including in a small study of 4 children. [45]

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