علاج التهاب الشرايين العقدي النشط الحاد مع المظاهر المهددة للحياة أو الأعضاء

References

DOI: 10.1002/art.41776

1. Severe disease: Vasculitis with life- or organ-threatening manifestations (e.g., renal disease, mononeuritis multiplex, muscle disease, mesenteric ischemia, coronary involvement, limb/digit ischemia)
2. For patients with newly diagnosed active, severe PAN, we conditionally recommend initiating treatment with intravenous (IV) pulse glucocorticoids over high-dose oral glucocorticoids.
3. For patients with newly diagnosed active, severe PAN, we conditionally recommend initiating treatment with cyclophosphamide and high-dose glucocorticoids over high-dose glucocorticoids alone.
4. Cyclophosphamide therapy should not continue indefinitely and should generally be limited to 3–6 months per course.
5. For patients with newly diagnosed PAN who have achieved disease remission with cyclophosphamide, we conditionally recommend transitioning to another nonglucocorticoid immunosuppressive agent over continuing cyclophosphamide.
6. For patients with PAN in remission who are receiving nonglucocorticoid immunosuppressive therapy, we conditionally recommend discontinuation of nonglucocorticoid immunosuppressive agents after 18 months over continued (indefinite) treatment.