From the Research
The treatment for Immunoglobulin A (IgA) vasculitis should prioritize glucocorticoids as the first-line therapy, especially in adults with severe manifestations, and consider rituximab for reducing relapse frequency and achieving long-term remission, as supported by the most recent study 1. The management of IgA vasculitis focuses on symptom control, as most cases resolve spontaneously within 4-6 weeks. For mild cases with skin manifestations, supportive care including hydration and rest is sufficient. Acetaminophen or NSAIDs like ibuprofen can help manage joint pain and fever, though NSAIDs should be avoided if kidney involvement is present.
- Key considerations in treatment include:
- Symptom management for mild cases
- Glucocorticoids for moderate to severe symptoms
- Immunosuppressive therapy for serious kidney involvement
- Monitoring of kidney function
- The use of rituximab has demonstrated efficacy in reducing relapse frequency and achieving long-term remission, particularly in cases with severe manifestations or kidney involvement, as noted in 1 and also seen in the context of other vasculitides 2.
- Other potential therapies, such as calcineurin inhibitors and mycophenolate mofetil, may also be considered, but the most recent and highest quality evidence supports the use of glucocorticoids and rituximab as primary treatments 1.
- The pathophysiology of IgA vasculitis involves IgA immune complex deposition in small blood vessels, triggering inflammation, which explains the effectiveness of immunosuppressive treatments in severe cases, as discussed in 3.