Churg-Strauss and treatment: I have just been... - Vasculitis UK

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Churg-Strauss and treatment

Maudy1 profile image
16 Replies

I have just been re-diagnosed with CSS having been treated specifically for GPA (Wegeners) for nearly 3 years, although I think I may have some cross over. I am on 6 monthly Rituximab but this has not controlled my symptoms well enough nor allowed adequate steroid reduction so I am trying Azathiaprine along side it. I was wandering if anybody has experience of both for CSS and had any success?

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Maudy1
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16 Replies
Suzym2u profile image
Suzym2uModeratorVasculitis UK

You are not the first to be diagnosed with WG before finally being diagnosed with CSS. We know someone who was diagnosed with WG for 4 years.

We also know someone else who was given Rituximab to treat the CSS, so will ask if they were also given Azathioprine. As I understand it Rituximab is not always successful for treating CSS but has been successful in a few cases. I believe there are different drug trials taking place at the moment for treating refractory CSS but only in the hospitals where the funding is available. I wil try and find out more for you

Susan

Maudy1 profile image
Maudy1 in reply toSuzym2u

Hi Susan, thanks for coming back to me. I have been to Addenbrookes and understand there is a drug on trial at the moment and they will know if they can use it next year. If you could find out from other's if a combination of Rituximab and Azathioprine has helped that would be very useful. Many thanks

Katie18 profile image
Katie18

I have CSS and was treated with high doses of steroid on a drip, then cyclophosphamide for 6 sessions and then 200mg aziathioprine alongside 30mg steroid a day steadily reducing. IT wasn't very pleasant but worked. I was treated with the same without the cyclophosphamide after a flare last winter.

Maudy1 profile image
Maudy1 in reply toKatie18

Hi Katie, can I ask are you still on Aziathioprine and what level of steriods are you on? Do you have ongoing symptoms or have you managed to achieve complete remission? Thanks Sally

Maudy1 profile image
Maudy1 in reply toKatie18

Hi Katie, sorry to bother you again but I was just wandering if when you first start Azathioprine you have a bit of reaction - I get worse sinuses, slightly wheezy and a bit itchy. This is very similar to my normal symptoms so difficult to know but it definitely makes it work - I'm hoping it will calm down. Thanks Sally

Katie18 profile image
Katie18

hi maudy I dont think you are in remission until you have been symptom free for a few years. im currently on 200mg aziathioprine - quite a high dose as my consultant believed I had s flare because they reduced my steriods and aziathioprine too quickly at once last time. I expect to be on it for anotther 3 years. im also on predisolone slowly reducing at 4mg a day st moment. Hope to be off this in about 6 months but see how it goes. ive got nerve damage and so will always have problems with my feet and some pain. i also have asthma now and suffer from fatigue and off days and prone to infections. But reasonably OK.

Maudy1 profile image
Maudy1 in reply toKatie18

Thats good to hear, I am struggling to get my steriods down, still at 19mg and nearly 3 years in. I suffer from sinus problems and asthma and some all over body pain but am hoping this time with the Rituximab and Azathioprine i will be gradually be able to taper.

Katie18 profile image
Katie18 in reply toMaudy1

Best of luck Maudy - when I reduce I tend to do a week reducing every other day. I have also reduced steroids by half getting a tool to cut tablets in half from chemist - that helps.

Rita83 profile image
Rita83 in reply toKatie18

Fatigue and nerve and muscle damage can really be a big problem even after remission,

Rita

Maudy1 profile image
Maudy1 in reply toRita83

My main problems are sinus related, asthma, skin flushing/itching and I just can not reduce my steroids. Hopefully I will one day.

Rita83 profile image
Rita83

When I was diagnosed with Churg Strauss there was a little doubt as to whether or not it might be Wegener', Granulomatosis. This was not thought then (27 years ago) as the treatment was the same.

Maudy1 profile image
Maudy1 in reply toRita83

Which treatment did you have and are you still on any medication? Thanks Sally

Rita83 profile image
Rita83

Twenty-seven years ago I was treated in St Thomas's Hospital, London with Azathioprine and prednisolone very successfully. Eventually I reduced to 1mg Prednisolone but problems returned about 4 years ago and I had to change hospitals. I then took both drugs again in higher doses but have now reduced to 25mg Azathioprine and 2.5mg Prednisolone.

Those are the only 2 drugs I have taken for CSS. I was told initially that the treatment is the same for WG and CSS but I do not know if that is still the case.

Maudy1 profile image
Maudy1

Thanks, hopefully I will get mine under control eventually. I hope you continue to do so well. Thanks for emailing me. Sally

Rita83 profile image
Rita83

27 years ago,having been diagnosed with CSS I was transferred to St Thomas's, London, where I was told that there was a possibility that I had Wegeners Granulomatosis but it was purely accademic since the treatment was the same.

Then 4 years ago, I had a relapse and, although it appears that there are now several different treatments, I am being treated at the Freeman Hospital in Newcastle with azathioprine and prednisolone, as at St Thomas's. This treatment seems to suit me. No other medication has been offered and I am content with my care.

Unfortunately, none of the GPs at my surgery knows about CSS so my 'problems' are not taken seriously but I am very fortunate in that I can contact my consultants at the Freeman if/when I need to. Their care is excellent.

Skipper55 profile image
Skipper55

Maudy1 I am on the same treatment for CSS , I have been on it a month and I feel terrible , It is a synthetic feel a real weird feeling , its supposed to slow the gut down and reduce pain in most areas including facial and give you more energy but to my mind , I am fuzzy in the head cannot think clearly and for pain reduction it has had no impact. These drugs have been called the new great treatment , its not worth a bar of soap .

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