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

Updated: Aug 31, 2021
  • Author: Christopher L Tracy, MD; Chief Editor: Herbert S Diamond, MD  more...
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Once induction of remission has occurred, treatment for maintenance of remission should be continued for at least 18 months, often longer

Azathioprine (2 mg/kg/day) is safer than, and as effective as, cyclophosphamide in maintaining remission [8]

Methotrexate (20-25 mg weekly, oral or subcutaneous) has been used for the maintenance of remission if the serum creatinine level is less than 1.5 mg/dL

Leflunomide (20-30 mg/day) is as effective as methotrexate, but it is associated with more adverse effects [9]

See Treatment and Medication for more detail.

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