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Diseases > Microscopic Polyangiitis (MPA) > What can I do about it?

What can I do about MPA?

Microscopic polyangiitis is a very serious disease. While there is no cure for MPA, it is treatable. Many people respond well to treatment. MPA 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 MPA or think you may have it, your family doctor should refer you to a specialist immediately. This is a very serious illness that should be treated early and aggressively. A rheumatologist is one of the best people to help you manage your condition. Some people will need to see a kidney specialist (nephrologist), lung specialist (respirologist) or nerve specialist (neurologist).

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 rheumatologist
  • Learn about the medications used to treat MPA. The RheumInfo website has many tools to help you understand these medications

Treatment of MPA

People with MPA can lead active and productive lives with the right kinds of treatment. Whatever treatment approach you choose it is essential to remember two key points: treat MPA early and treat it aggressively. Don’t wait. There are treatments available that can help get you back to leading a full life.

Why is it important to treat MPA early?

Research has shown us if you treat MPA 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 MPA 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 MPA is done it cannot be reversed. We want to stop MPA before it damages your blood vessels and tissues.

Why is it important to treat MPA 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 MPA

Corticosteroids (prednisone)

Medications like prednisone are very effective for controlling the inflammation of MPA. They may also prevent long-term damage in some people. As symptoms improve and markers of inflammation return to normal, the dose of prednisone can be gradually tapered and sometimes discontinued.

When used for long periods of time, prednisone can have side effects. Discuss the risks and benefits of using prednisone with your doctor.


A medication called cyclophosphamide is often used with prednisone to get the disease under control. It is very effective and most people achieve remission in 2 to 6 months. After 6 months, once the disease is under control, cyclophosphamide is switched to azathioprine (Imuran) or methotrexate.

Cyclophosphamide can increase your risk of infection. Cyclophosphamide can also affect your ability to have children.


Rituximab is a promising type of therapy called a “biologic” medicine. It is preferred for people who cannot take cyclophosphamide. It may also be appealing to women of childbearing age because it does not affect fertility. Rituximab can also increase your risk of infection.

Azathioprine (Imuran) & Methotrexate

In milder cases of MPA, azathioprine or methotrexate may be used to induce remission instead of cyclophosphamide. They are also used for maintenance therapy after 6 months of cyclophosphamide.

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

Exercises for MPA

Aerobic exercise such as walking, swimming or bicycling 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 MPA.  A good rule of thumb is to aim for 20-30 minutes of physical activity every day.

A trained arthritis physiotherapist can help design an exercise program tailored to you and your needs.

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

Natural or Home Remedies for MPA

There are no known natural remedies or complementary therapies that have been proven to help MPA 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.

MPA is a very serious disease that can result in death. It is important to use therapies that are proven to work. Natural therapies are not proven to work for MPA.

Diet for MPA

Questions about diet and MPA 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 MPA 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 MPA

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 MPA, some people may turn to alcohol to help cope with the distress. Alcoholic beverages are not an effective treatment for MPA. They can also interact with some medications including methotrexate or azathioprine.

Smoking and MPA

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

Concluding Thoughts

Microscopic polyangiitis is a very serious disease that can be life-threatening. It can also be a sneaky illness that goes undetected for some time. While it can be difficult to diagnose, it is very important to treat this disease early and aggressively. Medical therapy is essential.