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Treatments and drugs
By Mayo Clinic staffThere's no cure for Churg-Strauss syndrome, but certain medications may help even people with serious symptoms achieve remission. A good outcome and a reduced risk of complications from both the disease and its treatment are more likely when Churg-Strauss syndrome is diagnosed and treated early.
Medications used to treat Churg-Strauss syndrome include:
- Corticosteroids. Prednisone is the most commonly prescribed drug for Churg-Strauss syndrome. Your doctor may prescribe a high dose — 40 to 60 milligrams a day — of corticosteroids to get your symptoms under control as soon as possible. But because high doses of corticosteroids can cause serious side effects, including bone loss, high blood sugar, cataracts and hard-to-treat infections, your doctor will decrease the dose gradually until you're taking the smallest amount that will keep your disease under control. Even lower doses taken for extended periods can cause side effects, however.
- Other immunosuppressive drugs. For people with mild symptoms, a corticosteroid alone may be enough. Other people may require another immunosuppressive drug, such as cyclophosphamide (Cytoxan), azathioprine (Imuran) or methotrexate (Rheumatrex, Trexall), to reduce the body's immune reaction still further. Because these drugs impair your body's ability to fight off infection and can cause other serious side effects, your doctor must closely monitor your condition while you're taking them.
- Intravenous immunoglobulin (IVIg). Given as a monthly infusion, IVIg is the most benign of the treatments used for Churg-Strauss syndrome. The most common side effects are flu-like symptoms that usually last just a day or so. IVIg has two major drawbacks, however: It's very expensive, and it isn't universally effective. IVIg isn't considered a first line treatment for Churg-Strauss, but studies have shown that it can be helpful for people who don't respond to other medications.
Although drug therapy can quell symptoms of Churg-Strauss syndrome — and send the disease into remission — relapses are common.
- What is Churg Strauss syndrome? Churg Strauss Syndrome Association. http://www.cssassociation.org/about_the_syndrome.asp. Accessed Aug. 20, 2008.
- King TE. Churg-Strauss syndrome (allergic granulomatosis and angiitis). http://www.uptodate.com/home/index. Accessed Aug. 20, 2008.
- Churg Strauss syndrome. Vasculitis Foundation. http://www.vasculitisfoundation.org/churgstrausssyndrome. Accessed Aug. 20, 2008.
- Hellmich B, et al. Update on the pathogenesis of Churg-Strauss syndrome. Clinical and Experimental Rheumatology. 2003;21(6)(suppl):S69-S77.
- Lilly CM, et al. Asthma therapies and Churg-Strauss syndrome. The Journal of Allergy and Clinical Immunology. 2002;109(1):S1-S19.
- Weschler ME, et al. Churg-Strauss syndrome in patients receiving montelukast as treatment for asthma. Chest. 2000;117(3):708-713.
- Hauser T, et al. The leukotriene receptor antagonist montelukast and the risk of Churg-Strauss syndrome: A case-crossover study. Thorax. 2008;63:677-682.
- Tsurikisawa N, et al. Treatment of Churg-Strauss syndrome with high-dose intravenous immunoglobulin. Annals of Allergy, Asthma & Immunology. 2004;92(1):80-87.
