Polyarteritis Nodosa Medication

Updated: Jan 12, 2016
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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Medication

Medication Summary

Immunosuppression continues to be the standard therapy for polyarteritis nodosa (PAN). Corticosteroids plus cyclophosphamide (in the case of steroid-refractory disease or major organ involvement) can prolong survival for patients with idiopathic PAN.In contrast, for hepatitis B–related PAN, treatment consists of corticosteroids for early, initial control followed by plasmapheresis and antiviral agents. Stronger immunosuppression using a combinations of steroids and cyclophosphamide is typically avoided in these cases as it can enhance viral replication.

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Corticosteroids

Class Summary

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body's immune response to diverse stimuli.

Methylprednisolone (Solu-Medrol, Medrol, A-Methapred)

Methylprednisolone is a highly potent synthetic glucocorticoid that causes diverse metabolic effects and modifies the body's immune responses to various stimuli.

Prednisone

Prednisone, a synthetic glucocorticoid analog, acts as a potent immunosuppressant via its effects on multiple cell types and cytokines. It has anti-inflammatory, antipyretic, and, often, analgesic effects in addition to often-adverse metabolic effects.

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Antineoplastic agents

Class Summary

These agents are chemically related to nitrogen mustards. Because of its immunomodulatory properties, cyclophosphamide is used in conjunction with glucocorticoids, thus reducing the need for higher corticosteroid doses.

Cyclophosphamide

As an alkylating agent, the mechanism of action of the active metabolites of cyclophosphamide may involve cross-linking of deoxyribonucleic acid (DNA), which may interfere with the growth of normal and neoplastic cells.

Methotrexate (Rheumatrex, Trexall)

Methotrexate is a potent anti-inflammatory medication with antiproliferative effects used as a steroid-sparing agent.

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