Cyclophosphamide therapy of severe systemic necrotizing vasculitis

The New England Journal of Medicine
A S FauciS M Wolff

Abstract

We studied 17 patients with severe systemic necrotizing vasculitis over an 11-year-period. Sixteen patients were treated daily with cyclophosphamide (2 mg per kilogram per day), and one was treated with azathioprine (2 mg per kilogram per day). Before entering the study, all patients had active and progressive disease, even though 16 patients had been receiving corticosteroids that had caused severe and often incapacitating toxic side effects. Three patients died during the study. Complete and often dramatic remissions occurred in the surviving 14 patients, who were then placed on alternate-day corticosteroid treatment with continuation of cyclophosphamide. Corticosteroids were later discontinued in seven patients. The mean duration of remission was 22 months (range, two to 61). No patient showed recurrence of disease during treatment with cytotoxic agents.

References

Dec 31, 1998·Arthritis and Rheumatism·L Guillevin, F Lhote
Jan 27, 1999·Arthritis and Rheumatism·K RazaPaul Bacon
Jan 1, 1990·Arthritis and Rheumatism·J S Ratain, M C Hochberg
Dec 1, 1996·Arthritis and Rheumatism·E CirueloJ J Gómez-Reino
Aug 1, 1993·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·I RobertiJ Churg
Jun 1, 1986·Clinical Rheumatology·P OrienteA Pucino
Dec 1, 1983·Clinical Rheumatology·D G Scott, Paul Bacon
Sep 1, 1993·Clinical Rheumatology·M B AndrésdóttirA J Swaak
Nov 27, 2002·Indian Journal of Pediatrics·Surjit Singh, Rashna Dass
May 1, 1996·Indian Journal of Pediatrics·L Kumar, S Singh
Nov 1, 1987·Irish Journal of Medical Science·M McDermottM G Molloy
Mar 1, 1987·Irish Journal of Medical Science·A Reeves, B Bresnihan
Dec 1, 1989·Irish Journal of Medical Science·Y O'MearaJ Donohoe
Jul 18, 2001·Springer Seminars in Immunopathology·D Carruthers, Paul Bacon
Oct 10, 2001·Springer Seminars in Immunopathology·David R W Jayne
Dec 1, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Michael J DillonPaul A Brogan
Jan 9, 2008·Clinical Reviews in Allergy & Immunology·L Guillevin
Jun 7, 2012·Clinical Reviews in Allergy & Immunology·Cees G M Kallenberg
Nov 16, 2007·Comprehensive Therapy·H David PettigrewM Eric Gershwin
May 1, 1987·Immunology Letters·M S PalermoM A Isturiz
Jan 1, 1992·Clinical Neurology and Neurosurgery·R TopalogluA Oner
Feb 11, 1991·Mayo Clinic Proceedings·R W SchrinerJ V Donadio
May 30, 2001·Transplantation Proceedings·F J van der WoudeO Hotta
Feb 25, 2003·Lancet·Imre NothAlan R Leff
Jan 13, 2000·Clinics in Dermatology·G A Vena, N Cassano
Sep 15, 2001·European Journal of Internal Medicine·L Guillevin
Mar 22, 2001·Therapeutic Apheresis : Official Journal of the International Society for Apheresis and the Japanese Society for Apheresis·G MaticW Ramlow
Nov 15, 1979·The New England Journal of Medicine·D L Conn, J V Donadio
Jan 14, 1982·The New England Journal of Medicine·A S FauciS M Wolff
Jul 19, 1984·The New England Journal of Medicine·J C BailarM Polansky
Jul 4, 2003·The New England Journal of Medicine·David R W JayneEuropean Vasculitis Study Group
Jul 22, 2010·The New England Journal of Medicine·Rachel B JonesEuropean Vasculitis Study Group
Dec 5, 2002·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Caroline H ShiboskiSol Silverman

Citations

Apr 22, 1976·The New England Journal of Medicine·S GlanzN S Talner
Dec 1, 1977·Annals of Internal Medicine·A S Fauci
Sep 1, 1975·Arthritis and Rheumatism·M J RezaC M Pearson
May 1, 1970·Terapevticheskiĭ arkhiv·Z M Cherfas
Oct 1, 1974·Annals of Internal Medicine·S M WolffD C Dale
Apr 30, 1953·The New England Journal of Medicine·P M ZEEK

Related Concepts

Vasculitis
Necrosis
Cyclophosphamide
Remission, Spontaneous
Corticosteroid [EPC]
Recurrent Malignant Neoplasm
Corticosteroids, topical for treatment of hemorrhoids and anal fissures
Azathioprine
Cytotoxin
Cancer Remission

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Synapse Loss as Therapeutic Target in MS

As we age, the number of synapses present in the human brain starts to decline, but in neurodegenerative diseases this occurs at an accelerated rate. In MS, it has been shown that there is a reduction in synaptic density, which presents a potential target for treatment. Here is the latest research on synapse loss as a therapeutic target in MS.

Artificial Intelligence in Cardiac Imaging

Artificial intelligence (ai) techniques are increasingly applied to cardiovascular (cv) medicine in cardiac imaging analysis. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

Social Learning

Social learning involves learning new behaviors through observation, imitation and modeling. Follow this feed to stay up to date on the latest research.

Cell Atlas of the Human Eye

Constructing a cell atlas of the human eye will require transcriptomic and histologic analysis over the lifespan. This understanding will aid in the study of development and disease. Find the latest research pertaining to the Cell Atlas of the Human Eye here.

Single Cell Chromatin Profiling

Techniques like ATAC-seq and CUT&Tag have the potential to allow single cell profiling of chromatin accessibility, histones, and TFs. This will provide novel insight into cellular heterogeneity and cell states. Discover the latest research on single cell chromatin profiling here.

Genetic Screens in iPSC-derived Brain Cells

Genetic screening is a critical tool that can be employed to define and understand gene function and interaction. This feed focuses on genetic screens conducted using induced pluripotent stem cell (iPSC)-derived brain cells.