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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...

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Related Experiment Video

Updated: May 12, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
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Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Using cyclophosphamide in inflammatory rheumatic diseases.

Tobias Brummaier1, Erich Pohanka, Andrea Studnicka-Benke

  • 1Academic Research Unit, 2nd Department of Medicine, General Hospital Linz, Linz, Austria.

European Journal of Internal Medicine
|March 27, 2013
PubMed
Summary

Cyclophosphamide (CYC) is an effective immunosuppressive drug for autoimmune diseases but has a narrow therapeutic index and significant toxicity. This review details its use in rheumatology, focusing on properties, interactions, and managing adverse effects.

Keywords:
CyclophosphamideInflammatory rheumatic diseasesToxicity

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Last Updated: May 12, 2026

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Published on: May 16, 2025

Area of Science:

  • Immunopharmacology
  • Rheumatology
  • Oncology

Background:

  • Cyclophosphamide (CYC) is a potent immunosuppressive agent initially developed for cancer treatment.
  • It is now widely used for severe autoimmune conditions like systemic vasculitis and connective tissue diseases.
  • Despite its efficacy, CYC exhibits a narrow therapeutic index and considerable toxicity, necessitating careful management.

Purpose of the Study:

  • To provide a rheumatologist's perspective on the clinical application of cyclophosphamide.
  • To review the pharmacologic and pharmacokinetic properties of CYC relevant to rheumatic diseases.
  • To discuss drug interactions, toxicity profiles, and strategies for mitigating adverse effects of CYC in rheumatologic practice.

Main Methods:

  • Literature review of cyclophosphamide use in oncology and rheumatology.
  • Analysis of pharmacologic data, including drug interactions and toxicity.
  • Synthesis of information on preventive and therapeutic measures for CYC-related adverse events.

Main Results:

  • Data from oncology provides a basis for CYC use in rheumatology, but significant differences exist in disease characteristics and drug application.
  • Understanding CYC's pharmacology, pharmacokinetics, and toxicity is crucial for safe and effective use in inflammatory rheumatic diseases.
  • Management strategies for CYC toxicity are essential for optimizing patient outcomes.

Conclusions:

  • Cyclophosphamide remains a vital, albeit toxic, therapeutic option for severe inflammatory rheumatic diseases.
  • A comprehensive understanding of its properties and potential adverse effects is paramount for rheumatologists.
  • Careful monitoring and proactive management strategies are key to maximizing the benefits of CYC while minimizing risks.