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Treatments and drugs
By Mayo Clinic staffWith early diagnosis and appropriate treatment, you may recover from Wegener's granulomatosis within a few months. In some cases, longer treatment may be necessary. Because the disease can recur, your doctor will continue monitoring your condition after treatment.
Medications
Your doctor may prescribe:
- Corticosteroids. Medications such as prednisone help suppress the immune system and treat the early signs and symptoms of Wegener's granulomatosis.
- Immune suppressant medications. Most people require another immunosuppressive drug, such as cyclophosphamide (Cytoxan), azathioprine (Imuran) or methotrexate (Rheumatrex), to counteract the body's immune reaction.
When standard treatments aren't effective, some doctors who are experienced in treating Wegener's use experimental drugs. One such drug is rituximab (Rituxan). It reduces the number of a type of cell in your body (B cell) involved with inflammation. The most recent research suggests that rituximab may be as effective as cyclophosphamide in treating severe cases of Wegener's, and may be even better for treating Wegener's that recurs.
Side effect treatments
Because of potential side effects of the drugs used to treat Wegener's, such as hampering your body's ability to fight off infection, your doctor will monitor your condition while you're taking them. Drugs your doctor may prescribe to help prevent drug-related side effects include:
- Trimethoprim-sulfamethoxazole (Bactrim, Septra) to prevent lung infection
- Medicine such as bisphosphonates (Fosamax) to prevent bone loss (osteoporosis) associated with prednisone use
- Folic acid, a synthetic form of the B vitamin folate, to prevent sores and other signs and symptoms associated with the depletion of folate in your body from methotrexate use
Surgery
If you've had kidney failure as a result of Wegener's granulomatosis, you may consider a kidney transplant to restore normal kidney function. A successful transplant depends on finding an organ that minimizes the chances your body will reject it and following a treatment plan that will allow your body to accept the new organ.
Talk to your doctor to determine whether a kidney transplant might be an option for you. Your eligibility to receive a donated kidney will depend on how your other organs have been affected by the disease.
- Wegener's granulomatosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec04/ch033/ch033k.html#sec04-ch033-ch033k-362. Accessed July 26, 2010.
- Wegener's granulomatosis. National Institute of Allergy and Infectious Diseases. http://www.niaid.nih.gov/topics/wegeners/Pages/Default.aspx. Accessed July 26, 2010.
- Hellmann DB, et al. Musculoskeletal and immunologic disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment 2010. 49th ed. New York, N.Y.: McGraw Hill; 2010. http://www.accessmedicine.com/content.aspx?aID=10083. Accessed July 30, 2010.
- Langford CA, et al. The vasculitis syndromes. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=2859426. Accessed July 30, 2010.
- King TE, et al. Clinical manifestations and diagnosis of Wegener's granulomatosis and microscopic polyangiitis. http://www.uptodate.com/home/index.html. Accessed July 26, 2010.
- Stone JH, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. New England Journal of Medicine. 2010;363:221.
- Turnball J, et al. Adverse effects of therapy for ANCA-associated vasculitis. Best Practice and Research Clinical Rheumatology. 2009;23:391.
- Rosenow E (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 3, 2010.
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