Intensive induction therapy for polyarteritis nodosa
For an overview of high-dose systemic corticosteroid use for the management of systemic vasculitides, see Systemic corticosteroids for severe systemic vasculitis.
The appropriate route of administration and dosage of systemic corticosteroids for inducing remission in polyarteritis nodosa depends on the disease severity and whether it is affecting a major organ or body system. Patients with severe organ- or life-threatening disease (eg polyneuropathy, kidney or liver disease) require intensive induction therapy with pulse intravenous methylprednisolone; the usual dosage is:
methylprednisolone sodium succinate 0.5 to 1 g intravenously, over 1 hour, daily for 3 days, then switch to oral prednisolone (or prednisone) as below. methylprednisolone sodium succinate methylprednisolone methylprednisolone
For patients with milder forms of polyarteritis nodosa, without evidence of major organ or body-system involvement (eg disease affecting the skin only, or systemic symptoms only) intensive induction therapy may be initiated with high-dose oral corticosteroids; the usual dosage is:
prednisolone (or prednisone) 1 mg/kg up to 80 mg orally, daily for a minimum of 4 weeks. Depending on tolerability, the dose may be given in 2 divided doses. prednis ol one prednis(ol)one prednis(ol)one