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[Cyclophosphamide pulse therapy for refractory rheumatic diseases]

M Tateishi1, A Taniguchi, M Moriguchi

  • 1Institute of Rheumatology, Tokyo women's Medical College.

Nihon Rinsho Men'Eki Gakkai Kaishi = Japanese Journal of Clinical Immunology
|June 1, 1997
PubMed
Summary

Cyclophosphamide pulse therapy (CYP) shows efficacy in treating refractory rheumatic conditions like vasculitis and interstitial pneumonia. While adverse reactions occurred in 25.8% of patients, CYP is recommended for specific severe cases.

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Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Refractory rheumatic diseases pose significant treatment challenges.
  • Cyclophosphamide pulse therapy (CYP) is a potential therapeutic option for severe autoimmune conditions.

Observation:

  • Thirty-five patients with various refractory rheumatic diseases (SLE, RA, PM/DM, PSS, APS, MCTD, JRA, BD, WG, AGA) were treated with CYP.
  • Improvements were observed in patients with CNS lupus, vasculitis, interstitial pneumonia, refractory arthritis/myositis, and autoimmune thrombocytopenia.
  • Adverse reactions were reported in 9 out of 35 patients (25.8%).

Findings:

  • CYP demonstrated moderate to marked improvement in multiple refractory rheumatic disease subtypes.
  • Specific indications for CYP include central nervous system (CNS) disturbance, vasculitis, interstitial pneumonia (IP), and autoimmune thrombocytopenia.

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  • The overall adverse reaction rate was 25.8%.

    • Implications:

    • CYP is a viable treatment for specific refractory rheumatic diseases unresponsive to other therapies.
    • Careful patient selection is necessary due to potential adverse effects.
    • Further research may elucidate optimal CYP dosing and long-term outcomes in diverse rheumatic conditions.