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This combination therapy consists of the corticosteroids prednisone and methylprednisolone along with the immunosuppressant cyclophosphamide. It is used as a conventional induction treatment for systemic necrotizing vasculitides, including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA), and polyarteritis nodosa (PAN). Methylprednisolone is typically administered as intravenous pulses for rapid control of inflammation, followed by oral prednisone and cyclophosphamide (administered either orally or as intravenous pulses). The CORTAGE trial, sponsored by Assistance Publique - Hôpitaux de Paris, specifically evaluated this regimen in elderly patients (65 years and older) to compare standard dosing against a reduced-dose corticosteroid strategy to minimize treatment-related morbidity and mortality.
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