How is remission of granulomatosis with polyangiitis (GPA) induced?

Updated: Aug 31, 2021
  • Author: Christopher L Tracy, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Induction of remission in GPA is approached as follows:

  • Cyclophosphamide with high-dose glucocorticoids (criterion standard)

  • Rituximab with high-dose glucocorticoids

  • Methotrexate (oral or subcutaneous) with high-dose glucocorticoids, in non–organ-threatening or non–life-threatening GPA [6]

  • Plasma exchange may be considered in patients with rapidly progressive renal disease (serum creatinine level >5.65mg/dL) in order to preserve renal function [6]


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