Eosinophilic Fasciitis drugs

This page describes the most common drugs for treating EF, with links to sources in support of each drug. The Studies page has advice on the drugs recommended for most patients, while statistics compiled from patients show which DRUGS are actually being prescribed.

Prednisone

All the studies agree that systemic corticosteroids are the first-line therapy for Eosinophilic Fasciitis. Prednisone is the one most often prescribed. Current practice is for high doses at first then gradually reducing over months or years. Of interest is its effect of “reducing swelling and redness and by changing the way the immune system works”: https://medlineplus.gov/druginfo/meds/a601102.html

Prednisone is often accompanied by a second drug such as Methotrexate or Mycophenolate Mofetil (CellCept).
2017.Eosinophilic Fasciitis an Updated Review on Diagnosis and Treatment, Mazori, New York, USA [pdf]

Prednisolone

Prednisolone is similar to Prednisone (see link below). Prednisolone is often prescribed in the UK, Australia and New Zealand. what-is-the-difference-between-prednisone-and-prednisolone

MethylPrednisolone

Was found to be beneficial when administered in high doses at the outset of treatment:
2012.Eosinophilic Fasciitis – Best Practice – Lebeaux & Sène, Paris Diderot University, France [pdf]

Methotrexate

An immunosuppressant. The one most often prescribed.
2018.Eosinophilic Fasciitis – a case series with emphasis on therapy and remission, Tull, NC, USA [pdf]
2016.Predictors of Response to Methotrexate in Patients with Eosinophilic Fasciitis.Sifuentes-Giraldo.Spain [pdf]
2014.Eosinophilic Fasciitis – clinical characteristics and response to methotrexate, Berianu, Mayo Clinic, USA [pdf]

Hydroxychloroquine (Plaquenil)

This drug acts against malaria but is also prescribed for lupus erythematosus and rheumatoid arthritis: webmd
It is thought to help EF patients and is mentioned in several studies, including this one:
2008.Eosinophilic Fasciitis – report of 12 cases and review of the literature, Thomas Jefferson University, Philadelphia, USA [pdf]

Mycophenolate Mofetil (CellCept)

An immunosuppressant. The second most often prescribed after Methotrexate.
2020.Mycophenolate Mofetil for Eosinophilic Fasciitis – A Retrospective Analysis, Tkachenko, Massachusetts, USA [pdf]
2017.Eosinophilic Fasciitis an Updated Review on Diagnosis and Treatment, Mazori, New York, USA [pdf]
2016.Eosinophilic Fasciitis – An Analysis of 63 Patients, Brigham and Women’s Hospital, Boston, USA [pdf]

Azathioprine (Imuran)

An immunosuppressant. The next most often prescribed after Cellcept.
2017.Eosinophilic Fasciitis an Updated Review on Diagnosis and Treatment, Mazori, New York, USA [pdf]
2014.Eosinophilic Fasciitis morphea successfully treated with azathioprine, Alonso-Castro, Madrid, Spain [pdf]

IVIG (IgG)

Intravenous immunoglobulin (IVIG) contains the pooled immunoglobulin G (IgG) immunoglobulins from the plasma taken from a large pool of blood donors. It may be administered in hospital over the course of 1-3 days then repeated every 3-4 weeks. This 2009 report below concludes with “Data from a larger number of patients are needed to better assess the usefulness of IVIg therapy”. There do not seem to be any studies which have done this.
2009.IVIG used to successfully treat eosinophilic fasciitis, Pimenta, Portugal [pdf]

Cyclosporine

An immunosuppressant. Several studies mention these two case reports:
2010.Eosinophilic Fasciitis – A Rare Skin Sclerosis treated with Solumedrol then Prednisone and Cyclosporine, Servy, Paris, France [pdf]
2008.Long term remission by cyclosporine in a patient with eosinophilic fasciitis, Tahara, Tokyo, Japan [pdf]
2005.Eosinophilic fasciitis successfully treated with cyclosporine, Bukiej, Poland [pdf]

Infliximab (Remicade)

Described as a biologic medication for inflammatory diseases. Mentioned in these:
2017.Eosinophilic Fasciitis an Updated Review on Diagnosis and Treatment, Mazori, New York, USA [pdf]
2012.Eosinophilic Fasciitis – Best Practice – Lebeaux & Sène, Paris Diderot University, France [pdf]
2010.Eosinophilic Fasciitis – Infliximab may be effective – report of three cases, UCLA, Los Angeles, California, USA [pdf]

Rituximab (Rituxan)

A type of antibody therapy used to treat Non-Hodgkin’s Lymphoma and Chronic Lymphocytic Leukemia: what-is-rituxan
2006.Rituximab in refractory autoimmune diseases.Scheinberg.Brazil [pdf]

Cimetidine (Tagamet)

Cimetidine belongs to a class of drugs commonly called H2 blockers. It works by reducing the amount of acid in your stomach. WebMD
1982.Eosinophilic Fasciitis Responsive to Cimetidine.Solomon.New York.USA [pdf]

Tofacitinib (Xeljanz)

Prescribed for adults with moderate to severe rheumatoid arthritis MedlinePlus (see warning)
2017.Treatment of generalized deep morphea and eosinophilic fasciitis with tofacitinib, Yale, Connecticut.USA [pdf]
2020.Successful treatment of refractory eosinophilic fasciitis with tofacitinib, Cao, Beijing, China [pdf]

Albendazole (Albenza)

A patient was prescribed this drug to treat a parasite infection that was a suspected trigger in their EF:
2016.Eosinophilic Fasciitis after a parasite infection, Marta Oliveira, Portugal [pdf]

Leflunomide (Arava)

Used to treat adult moderate to severe rheumatoid arthritis: rheumatology.org
Although several EF patients have been prescribed this drug there appear to be no studies or case reports that recommend it as a treatment for Eosinophilic Fasciitis. It was prescribed for one patient in this study (Table 1):
2018.Eosinophilic Fasciitis – a case series with emphasis on therapy and remission, Tull, NC, USA [pdf]

Low Dose Naltrexone (LDN)

Although several EF patients have been prescribed this drug there appear to be no studies or case reports that recommend it as a treatment for Eosinophilic Fasciitis. It is described here: PMC3962576

Supplements

A calcium supplement with Vitamin D3 may be prescribed to offset the effect of Prednisone on the bones. Patients with osteoporosis (shown by a bone density scan) will be prescribed something for that as well. Magnesium may be prescribed for muscle cramps. Folic acid tablets when taking Methotrexate. Some patients add other supplements of their own choosing.

[updated: 2025-03-07]