CHUSPAN SCS BP Treatment of Churg-Strauss Syndrome Without Poor-Prognosis Factors
CHUSPAN SCS BP Treatment of Churg-Strauss Syndrome Without Poor-Prognosis Factors
To assess the efficacy of systemic corticosteroids alone as first-line treatment of
 Churg-Strauss syndrome without poor-prognosis factors as defined by the five-factor score
 (FFS=0), and to compare the efficacy and safety of azathioprine vs pulse cyclophosphamide as
 adjunctive immunosuppressive therapy to treat failure or relapse
All patients initially treated with systemic corticosteroids alone: optional IV
 methylprednisolone pulse (15 mg/kg) at treatment start followed by oral prednisone (1
 mg/kg/day) according to a tapering schedule. Treating physicians allowed to treat minor
 relapses with corticosteroids without referring the patient for randomization, as long as the
 prednisone dose did not exceed 0.5 mg/kg for 1 month.

 Patients in whom prednisone doses could not be tapered below 20 mg, those who failed to enter
 remission and those who relapsed were randomized to receive either 6 months of oral
 azathioprine (2mg/kg/day) or 6 cyclophosphamide pulses (0.6g/m2 D1, D15, D30 then every
 month)
Inclusion Criteria:

 -  Men and women with newly diagnosed Churg-Strauss syndrome;

 -  absence of poor prognostic factors as defined by the five-factor score (serum
 creatinine > 140 μmol/l or 1.58 mg/dl, proteinuria > 1 g/day, severe gastrointestinal
 tract involvement, specific cardiomyopathy and/or central nervous system involvement;

 -  written informed consent.

 Exclusion Criteria:

 -  age < 15 years, previously treated Churg-Strauss syndrome;

 -  history of cancer;

 -  pregnant or breast-feeding women;

 -  psychiatric disorders that might compromise compliance with therapy;

 -  contraindication to study drug;

 -  other ongoing therapeutic trial;

 -  concomitant viral hepatitis B or C or human immunodeficiency virus (HIV) infection