What is included the glucocorticoid regimen to induce remission in severe or generalized granulomatosis with polyangiitis (GPA)?

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

Severe disease, consider pulse methylprednisolone 500-1000 mg intravenous daily times 3 days

Otherwise recommend prednisone 1 mg/kg/day for at least 1 month, followed by taper (doses should not be reduced to less than 15 mg/day within the first 3 months; slowly taper to maintenance dose of 10 mg/day or less during remission

Recommend baseline evaluation of bone mineral density

Recommend daily calcium and vitamin D supplementation

Recommend consideration of bisphosphonate therapy to prevent glucocorticoid-induced osteoporosis, depending on renal function


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