What are the recommended first-line treatments for a patient diagnosed with EGPA, and how should I monitor their response to therapy?

First-line treatment for eosinophilic granulomatosis with polyangiitis (EGPA) typically involves systemic glucocorticoids to control inflammation and induce remission.

In cases with more severe or organ-threatening disease, immunosuppressive agents such as cyclophosphamide or rituximab may be added to glucocorticoids to improve outcomes and reduce relapse risk.

Monitoring response to therapy should include regular clinical assessment of symptoms and signs of disease activity, alongside laboratory markers such as eosinophil count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR).

Follow-up should be frequent initially (every 2–8 weeks in the first 6 months), then spaced out as the disease stabilizes, with vigilance for relapse or treatment side effects.

Specialist involvement (usually rheumatology) is essential for diagnosis confirmation, treatment initiation, and ongoing management.