Many systems can be involved and it is
important to adopt a team approach with good communication between the
specialists involved.
Because of involvement of auricular and
nasal cartilage, counselling, support and specialist cosmetic advice may be
required due to the change in facial appearance.
Medication
For patients with more mild disease,
nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin),
naproxen (Naprosyn), and others, can be helpful to control the inflammation.
Usually, however, cortisone-related medications (steroids such as prednisone
and prednisolone) are required. High-dose steroids are frequently necessary
initially, especially when the eyes or breathing airways are involved.
Moreover, most patient require steroids for long-term use.
Methotrexate (Rheumatrex, Trexall) has
shown promise as a treatment for relapsing polychondritis in combination with
steroids as well as a maintenance treatment. Studies have demonstrated that
methotrexate can help reduce the steroid requirements.
Other medications that have been tried in
small numbers of patients with some reports of success include cyclophosphamide
(Cytoxan), dapsone, azathioprine (Imuran), penicillamine (Depen, Cuprimine),
cyclosporine, anti-tumor necrosis factor (TNF) biologic medications (adalimumab
[Humira], infliximab [Remicade]), and combinations of these drugs with
steroids.
Surgery
Surgery may be required if
Collapse of upper airways may require
tracheostomy.
Males are more susceptible to heart valve
disease, possibly requiring aortic valve replacement
