Treatment of Relapsing Polychondritis in Inflammatory Joint Disease

Clinical Scenario

Relapsing polychondritis commonly involves the joints — joint involvement occurs in 52 to 85% of cases. The presentation is typically poly- or oligoarthritis, or acute to sub-acute arthralgia that may be migratory in character. This protocol is specifically structured for patients in whom inflammatory joint disease is part of the clinical picture.

Treatment Approach

Management in this setting involves background immunosuppressive therapy together with a carefully calibrated corticosteroid strategy. Long-term corticosteroid use is a recognised consideration, and corticosteroid-sparing approaches form part of the decision framework.

The complete protocol — including specific agents, sequencing, and thresholds — is available in the full regimen below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.revmed.2023.05.005

Joint involvement is very frequent (52 to 85%). It most often presents as poly- or oligoarthritis or acute or sub-acute arthralgia which may be migratory.

Background immunosuppressive therapy (preferably methotrexate) is warranted in cases of frequent use of corticosteroids, corticosteroid dependence or significant adverse events of NSAIDs and/or corticosteroids.

Prolonged corticosteroid therapy, which is often necessary, should not be prescribed on a long-term basis at more than 5–7.5 mg/day of prednisone without considering corticosteroid-sparing therapy.

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