Table 3.
Common treatment for systemic autoimmune diseases with audiovestibular involvement.
| Disease | Treatment | Reference |
|---|---|---|
| Systemic lupus erythematosus (SLE) | SLE without major organ manifestations: antimalarials and/or glucocorticoids; nonsteroidal anti-inflammatory drugs may be used judiciously for limited periods of time in patients at low risk for drug-induced complications; in nonresponsive patients, immunosuppressive agents such as azathioprine, mycophenolate mofetil, and methotrexate should also be considered | [38] |
| Cogan's syndrome (CS) | Prednisone 1 mg/kg/day for two weeks and then tapered over 3 to 6 months; methotrexate for long-term treatment; alternative treatments are cyclophosphamide, azathioprine, tacrolimus, and rituximab | [45] |
| Sarcoidosis | High dose of corticosteroids (20–40 mg/daily) for 6 to 18 months; high-dose intravenous n-methyl-prednisone with doses of up to 30 mg/kg for 1–5 days has been commonly recommended for treatment of refractory neurosarcoidosis; in addition, methotrexate, azathioprine, and TNF-alpha antagonists | [51] |
| Rheumatoid arthritis (RA) | Methotrexate at disease onset (10–15 mg/week) and then 20 mg/week for 4–8 weeks; it is possible to use prednisolone at high dosage (40–60 mg) and tapering to 7.5 mg at week 6 for a total of 12 weeks | [140] |
| Antiphospholipid syndrome (APS) | Chronic treatment with low dose of acetylsalicylic acid | [57] |
| Polyarteritis nodosa (PAN) | PAN without viral syndrome: prednisone 1 mg/kg/day and then tapering when remission is reached | [71] |
| Behcet's disease (BD) | Steroid treatment with azathioprine; for resistant cases, azathioprine + interferon + TNF-α antagonists | [45] |
| Takayasu's arteritis (TA) | Prednisone 1 mg/kg/day; additionally, it is possible to use immunosuppressants such as methotrexate, azathioprine, mycophenolate mofetil, leflunomide, tacrolimus, and TNF-alpha antagonists | [79] |
| Relapsing polychondritis (RP) | Corticosteroid treatment at high dosages; in addition, colchicine, methotrexate, azathioprine, intravenous immunoglobulins, minocycline, and leflunomide | [93] |
| Wegener granulomatosis (WG) | Prednisone or equivalent 1 mg/kg/day, sometimes preceded in severe cases by intravenous methylprednisolone pulses (7.5–15 mg/kg/day) for 1–3 consecutive days; after two weeks, tapering with a decrease of 10% every two weeks for a total of 6 months; in case of long-term treatment (>2 years), 5 mg/day; is also possible to use cyclophosphamide and rituximab for maintenance therapy | [141] |
| Susac syndrome (SS) | High-dosage corticosteroids; additionally, intravenous immunoglobulin, plasma exchange azathioprine, mycophenolate mofetil, methotrexate, cytochrome P450 enzymes, and cyclosporine A | [103] |
| Sjögren's syndrome (pSS) | Cyclosporine A for local treatment of eye disease; colchicine and steroid treatment are used; controversial use of rituximab | [110] |
| Myasthenia gravis (MG) | Immunosuppressant therapy; in addition, treatment with insulin,thyroid hormones, and pyridostigmine | [120] |
| Multiple sclerosis (MS) | Immunomodulating therapy: T cell suppressor (alemtuzumab, daclizumab); B-cell modulators (rituximab, ocrelizumab); unique anti-inflammatory agents (laquinimod); hormones (estriol); 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors; vitamin D | [130] |
Treatment options for systemic autoimmune conditions, along with relevant references.