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Diseases > Eosinophilic Granulomatosis with Polyangiitis (EGPA) > What can I do about it?

What can I do about EGPA?

EGPA is a very serious disease. While there is no cure for EGPA, many people respond well to treatment. Remember, EGPA is a disease that tends to flare. That means that you may have periods where your symptoms are well controlled and other times they flare up again.

If you have EGPA or think you may have it, your family doctor should refer you to a specialist. A rheumatologist is one of the best people to help you manage your condition. Some people will need to see a lung specialist (respirologist), a nerve specialist (neurologist) or a kidney specialist (nephrologist).

Here are some other recommendations:

  • Learn as much as you can about this disease. Knowledge is power and we’ve aimed to develop this RheumInfo website so it’s easy to understand
  • Attend your rheumatologist appointments regularly
  • Get your blood tests done as suggested by your doctor
  • Learn about the medications used to treat EGPA. The RheumInfo website has many tools to help you understand these medications

Treatment of EGPA

People with EGPA can lead active and productive lives with the right kinds of treatment. It is essential to treat EGPA early and treat it aggressively. It’s also important to keep your asthma under control with standard asthma therapies.

Why is it important to treat EGPA early?

Research has shown us if you treat EGPA early you are much more likely to get into remission (when there are no more symptoms and markers of inflammation are back to normal). Even a few months can make a difference. You can think of EGPA like a fire in your small blood vessels and organs. You want to get that fire put out as quickly as possible so it doesn’t damage your body. Once the damage from EGPA is done it cannot be reversed. We want to stop EGPA before it damages your blood vessels and tissues.

Why is it important to treat EGPA aggressively?

Using the same fire analogy, we’ve decided to call in the fire department. Now we need to make sure we have the right tools to put out the fire. We don’t want a bucket and water. We want a fire truck with a big hose. The faster we can get that fire out the less damage is done and the better things will be in the long run.

Medications for EGPA

Corticosteroids (prednisone)

The primary therapy for EGPA is prednisone. This medicine is very effective at controlling the inflammation of EGPA. As symptoms improve and markers of inflammation return to normal, the dose of prednisone can be gradually tapered and sometimes discontinued. Some patients will need to remain on a low dose of prednisone, which can be safe and effective.

Cyclophosphamide

If other organs are affected, another medication called cyclophosphamide may be required. It is often used with prednisone to get the disease under control.

Azathioprine (Imuran) & Methotrexate

People who have been on cyclophosphamide for 6 months are usually switched to azathioprine or methotrexate as a long-term maintenance therapy. In milder cases of EGPA, azathioprine may be used to induce remission instead of cyclophosphamide.

For more information about specific medications used to treat EGPA, refer to the “pictopamphlets” in the Medications section of this website.

Exercises for EGPA

A trained arthritis physiotherapist can help design an exercise program tailored to you and your needs. If you are able, aerobic exercise such as walking, swimming or bicycling is important. It works your heart and increases your overall fitness and health.  Regular physical activity can also help you deal with fatigue and is an important part of keeping a healthy weight. The level and amount of exercise you can do depends on the extent and activity of your EGPA.

For patients with nerve involvement, supervised exercise regimens are an important part of treatment. A physiotherapist or occupational therapist can help people regain fitness after they have been hospitalized.

Read these useful articles on exercising with arthritis – many of the tips can also be applied to people with EGPA:

Natural or Home Remedies for EGPA

There are no known natural remedies or complementary therapies that have been proven to help EGPA in any significant way. However, it’s important to check with your rheumatologist to make sure that nothing interacts with your medication if you choose to use natural remedies or complementary therapies.

EGPA is a very serious disease. It is important to use therapies that are proven to work. Natural therapies are not proven to work for EGPA.

Diet for EGPA

Questions about diet and EGPA are very common. We all want to know what we can do to help ourselves. Can we change our diet to improve our immune system and help our condition? Changing our diet gives us a sense of control over a disease which often seems to have a mind of its own.

Unfortunately, there is no diet that has been proven to significantly alter the course of EGPA or other types of inflammatory arthritis. Eating well can help you keep a healthy weight and reduce your risk of diabetes, which can be associated with long-term use of prednisone.

Alcohol and EGPA

Many of us like to share a glass of wine, a beer or a spirit from time to time. Unfortunately, due to the nature of EGPA, some people may turn to alcohol to help cope with the distress. Alcoholic beverages are not an effective treatment for EGPA. They can also interact with some medications including methotrexate or azathioprine.

Smoking and EGPA

Cigarette smoking, whether you have EGPA or not, has no positive effects on any aspect of your health. Smoking can worsen the symptoms of EGPA by breathing toxic chemicals into airways that are likely already affected by the disease. So if you are a smoker with EGPA, quitting could be one of the best things you can do to improve your overall health.

Concluding Thoughts

EGPA is a rare but potentially life-threatening disease. If you have asthma and it seems to be getting worse, along with other symptoms that are not usual for you, see your doctor right away. The sooner you are diagnosed and treated, the better off you’ll be.