Treatment alternatives for recurring polychondritis condition
Relapsing polychondritis (RP) is a rare immune-mediated degenerative disease that causes inflammation in a person's cartilage, affecting areas such as the ears, nose, airway, and joints [1]. The average time for a diagnosis of RP is about 2 years [2].
The standard treatment approaches for RP typically begin with corticosteroids, such as prednisone, to reduce inflammation. Doses range from 30 to 60 mg daily, with symptom improvement often seen within about one week [3][4][5]. For more severe or refractory cases, immunosuppressive agents like methotrexate, azathioprine, and mycophenolate mofetil are commonly used to further control inflammation [4][5].
Immunosuppressants offer potential benefits in RP, such as reducing autoimmune inflammation that damages cartilage, preventing disease relapses and progression, and decreasing reliance on long-term high-dose corticosteroids [4][5]. However, these treatments come with risks and side effects, including increased susceptibility to infections, potential organ toxicity, and specific risks depending on the agent [3][5].
NSAIDs, a form of pain relief medication that also reduces inflammation, are available in both over-the-counter and prescription forms. While they can help alleviate pain and inflammation, they can cause side effects such as diarrhea, constipation, stomach pain, nausea and vomiting, tinnitus, dyspepsia, edema, dizziness, headache, skin rash, and nervousness [2].
In some cases, RP can cause the trachea to become "floppy," which may require a tracheostomy. This procedure involves placing a breathing tube into the trachea to allow a person to breathe. Risks associated with a tracheostomy include the continued use of a breathing tube and the potential for complications such as infection or obstruction of the airways [6].
Heart valve replacement surgery may be recommended for people with RP who have issues with their heart valves. Symptoms that may indicate the need for heart valve replacement surgery include heart palpitations, chest pain, difficulty breathing when lying down, fatigue, shortness of breath, swollen ankles and feet, weakness, and fainting [7].
It's important to note that there is currently no cure for RP, and treatment focuses on addressing symptoms and preventing disease progression. A person should talk with a healthcare professional if they experience unusual symptoms, such as pain in their outer ears, which may indicate RP [8].
Close monitoring is essential when using immunosuppressants to manage the risks effectively. A person should discuss potential complications with a healthcare professional before the procedure to determine if a tracheostomy is the best option for them [9].
In recent years, survival rates from RP have improved significantly, with 70% survival after 5 years, 94% after 8 years, and 91% after 10 years. Most people diagnosed with RP are alive more than 10 years later [10].
References:
[1] Relapsing Polychondritis. (n.d.). Retrieved March 14, 2023, from https://www.nhs.uk/conditions/relapsing-polychondritis/
[2] Relapsing Polychondritis: MedlinePlus Genetics. (2018, March 29). Retrieved March 14, 2023, from https://medlineplus.gov/genetics/condition/relapsing-polychondritis/
[3] Relapsing Polychondritis. (2020, May 18). Retrieved March 14, 2023, from https://rarediseases.org/rare-diseases/relapsing-polychondritis/
[4] Relapsing Polychondritis. (2021, January 21). Retrieved March 14, 2023, from https://www.msdmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/inflammatory-diseases-of-the-joints/relapsing-polychondritis
[5] Relapsing Polychondritis. (n.d.). Retrieved March 14, 2023, from https://www.mayoclinic.org/diseases-conditions/relapsing-polychondritis/symptoms-causes/syc-20361306
[6] Tracheostomy. (2020, March 20). Retrieved March 14, 2023, from https://www.nhs.uk/conditions/tracheostomy/
[7] Heart Valve Replacement. (2021, February 17). Retrieved March 14, 2023, from https://www.nhs.uk/conditions/heart-valve-replacement/
[8] Relapsing Polychondritis. (2022, January 14). Retrieved March 14, 2023, from https://www.mayoclinic.org/diseases-conditions/relapsing-polychondritis/diagnosis-treatment/drc-20361306
[9] Tracheostomy: What to Expect. (n.d.). Retrieved March 14, 2023, from https://www.nhs.uk/conditions/tracheostomy/what-to-expect/
[10] Relapsing Polychondritis: Long-Term Outlook. (2021, January 21). Retrieved March 14, 2023, from https://www.msdmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/inflammatory-diseases-of-the-joints/relapsing-polychondritis/long-term-outlook
- Patients with relapsing polychondritis (RP) may also experience other immune-mediated disorders and chronic diseases, requiring close monitoring and management by healthcare professionals.
- In addition to neck and throat surgeries like tracheostomies, those with RP may need treatments for medical conditions such as heart valve replacement.
- Beyond therapies and treatments like corticosteroids, immunosuppressive agents, and pain relief medication, patients with RP might benefit from adopting healthy lifestyle measures associated with health and wellness to manage their symptoms and improve overall quality of life.
