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Intermittent cyclophosphamide in refractory rheumatoid arthritis
British Medical Journal (Clinical Research Ed.)
|September 10, 1983
Summary
This study shows that intermittent cyclophosphamide, sometimes with methylprednisolone pulses, can induce long-term remission in severe rheumatoid arthritis patients. Treatment led to sustained remission, with manageable side effects like leucopenia.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease causing joint inflammation and damage.
- Refractory RA cases often require aggressive treatment strategies.
- Current treatments may have limited efficacy or significant side effects in some patients.
Observation:
- Three patients with refractory rheumatoid arthritis were treated with oral cyclophosphamide.
- Two patients also received pulse methylprednisolone therapy.
- Treatment outcomes and side effects were monitored.
Findings:
- Long-term remission was achieved in all three patients.
- Remission was sustained for at least nine months after discontinuing methylprednisolone.
- Leucopenia (low white blood cell count) occurred but resolved upon reducing cyclophosphamide dosage to intermittent administration.
Implications:
- Intermittent cyclophosphamide, potentially combined with methylprednisolone pulses, offers a viable treatment option for refractory RA.
- This approach may induce sustained remission in patients unresponsive to other therapies.
- Careful monitoring and dose adjustment can manage treatment-related side effects like leucopenia.