Treatment of Active Nonsevere Polyarteritis Nodosa Without Life- or Organ-Threatening Manifestations
This protocol addresses newly diagnosed active polyarteritis nodosa that is nonsevere — where the disease is active but without critical organ involvement — and outlines the approach to achieving clinical remission.
Clinical Scenario
Active nonsevere polyarteritis nodosa without life- or organ-threatening manifestations: vasculitis presenting with mild systemic symptoms, uncomplicated cutaneous disease, or mild inflammatory arthritis, without evidence of life-threatening or major organ-threatening involvement.
Treatment Approach
Current evidence supports combination immunosuppressive therapy — pairing a nonglucocorticoid immunosuppressive agent with glucocorticoids — rather than glucocorticoids alone. The complete regimen, sequencing, and follow-up strategy are detailed in the full protocol.
Treatment goal: clinical remission — absence of clinical signs or symptoms attributed to polyarteritis nodosa.
References
DOI: 10.1002/art.41776
Nonsevere disease: Vasculitis without life- or organ-threatening manifestations (e.g., mild systemic symptoms, uncomplicated cutaneous disease, mild inflammatory arthritis)
For patients with newly diagnosed active, nonsevere PAN, we conditionally recommend treating with nonglucocorticoid immunosuppressive agents and glucocorticoids over glucocorticoids alone.
Although some patients achieve disease remission while receiving glucocorticoids alone, a substantial number of patients ultimately require additional nonglucocorticoid therapy, usually azathioprine or methotrexate.
Absence of clinical signs or symptoms attributed to PAN, on or off immunosuppressive therapy
View source ↗