Step-down approach using either cyclosporin A or methotrexate as maintenance therapy in early rheumatoid arthritis

Arthritis and Rheumatism
A MarchesoniS Tosi

Abstract

To evaluate the feasibility and outcome of the step-down approach using either cyclosporin A (CSA) or methotrexate (MTX) as maintenance therapy following 6 months treatment with these 2 agents in combination in early, nonerosive rheumatoid arthritis (RA). Fifty-seven patients younger than 65 years with early, nonerosive RA were first treated with CSA and MTX in combination for 6 months. They were then randomly stepped down to single-agent maintenance treatment for another 18 months. Safety, clinical efficacy, survival on treatment, and radiographic progression were evaluated. When being treated with combination therapy, 7 of the 57 patients (12.3%) withdrew because of adverse events. Of the remaining 50 patients, 42 (84.0%) were American College of Rheumatology (ACR) 20% responders, 30 (60.0%) were ACR 50% responders, and 23 (46.0%) were ACR 70% responders. At month 6, 22 patients were randomized to CSA and 27 to MTX. During this trial period, the treatment was discontinued by 16 patients taking CSA (mainly because of loss of efficacy) and by 4 taking MTX. At month 24, the probability (+/- SEM) of survival on treatment was 0.273 +/- 0.09 for CSA and 0.852 +/- 0.07 for MTX. Of the 6 CSA patients who completed the trial, 4 (66.7%...Continue Reading

References

Dec 1, 1990·Seminars in Arthritis and Rheumatism·R SegalB Tartakovsky
Jun 1, 1996·Arthritis and Rheumatism·G PaseroO Della Casa-Alberighi
Sep 1, 1996·Clinical Immunology and Immunopathology·S HoG R Crabtree
Dec 1, 1996·Arthritis and Rheumatism·B N Cronstein
May 1, 1997·Current Opinion in Rheumatology·G Stucki, T Langenegger
Oct 20, 1998·Arthritis and Rheumatism·A M van GestelP L van Riel
Feb 22, 2002·Arthritis and Rheumatism·William P. Arend

❮ Previous
Next ❯

Citations

Aug 1, 2007·Nature Clinical Practice. Rheumatology·James DaleRajan Madhok
Apr 30, 2005·Annals of the Rheumatic Diseases·E Suresh, C M Lambert
Aug 6, 2003·BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy·Hanns-Martin Lorenz
Apr 13, 2011·Archives of Internal Medicine·Lisa G SuterR Scott Braithwaite
Mar 1, 2006·Expert Opinion on Investigational Drugs·Felix Braun, Matthias Behrend
Oct 20, 2006·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·J-H Yen
Aug 16, 2016·Clinical Reviews in Allergy & Immunology·Cecilia Beatrice ChighizolaPier Luigi Meroni
Aug 20, 2016·BMC Musculoskeletal Disorders·Jeroen P JansenGene V Wallenstein

❮ Previous
Next ❯

Related Concepts

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.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

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.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. 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.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.