Treatment of Relapsing Polychondritis in Inflammatory Joint Disease

Inflammatory joint involvement is among the most common manifestations of relapsing polychondritis. When joint disease is a dominant feature, the treatment protocol is shaped by both the systemic nature of the condition and the specific articular presentation.

Clinical Scenario Relapsing polychondritis presenting with inflammatory joint disease. Joint involvement occurs in the majority of patients and most often takes the form of poly- or oligoarthritis, or acute to sub-acute arthralgia that may be migratory in character.

Treatment Approach Management in this setting involves immunosuppressant therapy and, where indicated, targeted biologic agents. The selection and combination of these approaches depends on the full clinical picture — the complete protocol specifies the options and the criteria that guide them.

Instant Access to Structured Evidence-Based Regimens

References

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.

If methotrexate fails, a second-line immunosuppressant (including azathioprine, mycophenolate mofetil and leflunomide) and/or targeted therapy (preferably anti-TNF or IL-6 receptor inhibitor) may be used. The use of cyclophosphamide, a potent immunosuppressant, is not indicated in joint disease due to a poor benefit–risk ratio.

DOI: 10.1016/j.revmed.2023.05.005

View source ↗