The treatment of vasculitis depends on its cause:
Polyarteritis nodosa – This form of vasculitis usually is treated with prednisone (sold under several brand names) and, in most cases, cyclophosphamide (Cytoxan, Neosar).
Hypersensitivity vasculitis – This form goes away on its own without treatment. For severe cases, prednisone may be given.
Giant cell arteritis – Treatment begins with high doses of prednisone, which gradually are reduced over many months. If symptoms return, a lower dose may be necessary for a year or more. Additional medications, such as methotrexate, may be recommended although their overall benefit is not clear.
Granulomatosis with polyangiitis (Wegener's) Wegener's granulomatosis – Treatment Standard treatment begins withincludes prednisone and along with cyclophosphamide or rituximab, but then prednisone gradually is reduced and the patient continues to take only cyclophosphamide, often for a year or more. Methotrexate (Rheumatrex, and others) or other immune-suppressing medications may be used in people who cannot tolerate cyclophosphamide.
Takayasu's arteritis – Prednisone is used to treat symptoms. Narrowed arteries may need to be corrected with surgery or angioplasty (inserting a balloon-tipped catheter to widen the vessels).
Kawasaki disease – Treatment includes aspirin and a drug called gamma globulin given in high doses intravenously (into a vein) to reduce the risk of coronary artery damage.
There are a number of other types of vasculitis. Depending on the severity and type of vasculitis, other immune-suppressing medications may be recommended, including azathioprine (Imuran) or methotrexate. In some cases of vasculitis, a procedure called plasma exchange may be recommended. With plasma exchange, blood is taken out of the patient, the liquid portion of the blood (called plasma) is removed and theblood cells along with plasma from a blood donor are then transfused back into the person.