The drug of choice for treating autoimmune hemolytic anemia (AIHA) depends on the underlying cause and the severity of the condition. Corticosteroids are the mainstay of AIHA treatment and are usually the first line of treatment. If corticosteroids do not provide adequate relief, other treatments such as rituximab, cyclophosphamide, or splenectomy may be indicated.
Corticosteroids
Corticosteroids such as prednisone are the first-line treatment for AIHA. They work by reducing the body's production of antibodies that are attacking the red blood cells. Corticosteroids are usually very effective at reducing symptoms and can be taken orally or injected. They may need to be taken for several months to keep the disease in remission.
Rituximab
Rituximab is a monoclonal antibody that targets a specific type of white blood cell called B-cells. It is used in AIHA when corticosteroids are not sufficient to control the disease. Rituximab is given as an intravenous infusion and can provide sustained remission of AIHA.
Cyclophosphamide
Cyclophosphamide is another drug that is used to treat AIHA when corticosteroids and rituximab are not effective. It is an immunosuppressant drug that suppresses the immune system and reduces the production of antibodies. Cyclophosphamide is usually given as a short course of treatment and can be effective in controlling the disease.
Splenectomy
In some cases of AIHA, a splenectomy (surgical removal of the spleen) may be necessary to reduce the destruction of red blood cells. This procedure is usually reserved for severe cases of AIHA that are not responding to other treatments. It can be effective in controlling the disease, but there is a risk of infection after the surgery.
