From the Research
The best treatment for mesenteric panniculitis is corticosteroids, such as prednisone, which are typically first-line therapy due to their anti-inflammatory properties, as supported by the most recent study 1. When considering treatment options for mesenteric panniculitis, it's essential to prioritize symptom severity, as there is no standardized approach.
- For asymptomatic patients, observation without medication is often recommended, as the disease is benign and may not require intervention.
- For patients with symptoms, corticosteroids like prednisone (starting at 40mg daily with gradual tapering) are typically first-line therapy, as seen in a case study where a patient's symptoms disappeared totally within 1 month after oral prednisone 40 mg per day 2.
- Tamoxifen may be added to help reduce fibrosis, although its use is not universally recommended.
- For patients who don't respond adequately to corticosteroids, immunosuppressants such as azathioprine, cyclophosphamide, or methotrexate may be considered, as well as colchicine for milder cases.
- Thalidomide has shown effectiveness in refractory cases, but its use should be carefully considered due to potential side effects. The rationale for these treatments centers on controlling the inflammatory process and preventing progression to fibrosis, which characterizes this rare inflammatory disorder affecting the mesenteric fat, as described in a comprehensive review of the disease 1. Regular monitoring for medication side effects and disease progression is essential, and treatment duration varies but typically continues until symptoms resolve, often several months, as noted in a clinical review of mesenteric panniculitis 3.