What are the best treatments for Relapsing Polychondritis?

The primary treatment for relapsing polychondritis focuses on reducing inflammation and preventing permanent cartilage damage, typically using corticosteroids as the first-line therapy. Because relapsing polychondritis is a systemic autoimmune condition, treatment plans are highly personalized and often require a multidisciplinary medical team to manage flares and protect vital organs like the airway and heart.

What are the first-line and maintenance medications for relapsing polychondritis?

Management of relapsing polychondritis generally begins with oral corticosteroids, such as prednisone, to rapidly control inflammation during active flares. For patients who require long-term maintenance or who cannot taper off steroids, clinicians often introduce "steroid-sparing" agents. These medications, which modulate the immune system to prevent further cartilage destruction, include:

• Methotrexate (Trexall)


• Azathioprine (Imuran)


• Cyclophosphamide (Cytoxan), typically reserved for severe, life-threatening organ involvement


• Dapsone or Colchicine, sometimes used for milder, localized cases


• Biologic therapies such as infliximab (Remicade) or tocilizumab (Actemra) for refractory cases

What non-pharmacological and surgical interventions are used?

While medication is the cornerstone of therapy for relapsing polychondritis, non-pharmacological support is essential. Physical and occupational therapy are vital for maintaining joint mobility in patients with polyarthritis. In severe cases where relapsing polychondritis causes structural airway collapse or significant heart valve damage, surgical intervention—such as tracheostomy, airway stenting, or cardiac valve replacement—may be necessary to maintain life-sustaining functions.

How does the multidisciplinary care team work?

Because relapsing polychondritis affects multiple body systems, including the respiratory, skeletal, and circulatory systems, effective management requires a coordinated approach. A patient’s care team should ideally include a rheumatologist to lead the immunosuppressive strategy, alongside specialists such as pulmonologists (for airway involvement), ophthalmologists (for eye inflammation), and cardiologists. With 468 members on DiseaseMaps.org sharing their experiences, we see firsthand how vital this collaborative, patient-centered approach is to managing the fluctuating nature of this disease.

Next steps

• Consult with a board-certified rheumatologist to establish a tailored, systemic treatment plan.


• Monitor for early warning signs of airway involvement, such as a persistent cough or difficulty breathing.


• Join the DiseaseMaps community to connect with others managing relapsing polychondritis.


• Keep a symptom journal to track flare triggers and medication responses to share with your care team.

Medical disclaimer: This information is for educational purposes only and does not constitute medical advice; please consult with your healthcare provider for personalized diagnosis and treatment.

References

• NIH Genetic and Rare Diseases Information Center (GARD): Relapsing Polychondritis.


• Orphanet: Relapsing Polychondritis (ORPHA:732).


• The Relapsing Polychondritis Foundation: Patient Education and Research Resources.


• PubMed: Clinical guidelines and systematic reviews on immunosuppressive therapies for rare autoimmune diseases.