Treatment
Treatment
About 50% of patients with polyarteritis nodosa achieve remissions or cures with high doses of corticosteroids alone. Cyclophosphamide is required for patients who do not respond to steroids.
About 50% of patients with polyarteritis nodosa achieve remissions or cures with high doses of corticosteroids alone. Cyclophosphamide (a drug used in treating cancers and autoimmune diseases) is required for patients who do not respond to steroids and those with serious involvement of major organs. Methotrexate and azathioprine are other drugs of use. Hypertension should be treated aggressively with anti hypertensive drugs like ACE inhibitors.
The treatment of HBV-associated polyarteritis nodosa has improved ever since drugs like lamivudine came into vogue. The increasing use of the HBV vaccine has resulted in fewer cases of PAN associated with hepatitis B.
With treatment, 5-yr survival in a patient with Polyarteritis Nodosa is more than 80%. This may be lower in those with hepatitis B. Better survival can be ensured if treatment is initiated early and disease remission is achieved within 18 months after diagnosis. Involvement of the kidneys, digestive tract or nervous system is associated with a poor prognosis.
References:
- Cecil Medicine, 23rd Ed.
- The Merck Manual, 18th Ed.
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