Treatment of intractable rheumatoid arthritis with combined cyclophosphamide, azathioprine, and hydroxychloroquine. A follow-up study.
Identifieur interne : 003362 ( Main/Exploration ); précédent : 003361; suivant : 003363Treatment of intractable rheumatoid arthritis with combined cyclophosphamide, azathioprine, and hydroxychloroquine. A follow-up study.
Auteurs : M. Csuka ; G F Carrera ; D J MccartySource :
- JAMA [ 0098-7484 ] ; 1986.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Association de médicaments, Azathioprine (effets indésirables), Azathioprine (usage thérapeutique), Cyclophosphamide (effets indésirables), Cyclophosphamide (usage thérapeutique), Facteur rhumatoïde (analyse), Femelle, Humains, Hydroxychloroquine (effets indésirables), Hydroxychloroquine (usage thérapeutique), Hémoglobines (analyse), Immunoglobuline M (analyse), Mâle, Numération des leucocytes, Polyarthrite rhumatoïde (), Polyarthrite rhumatoïde (imagerie diagnostique), Polyarthrite rhumatoïde (sang), Polyarthrite rhumatoïde (traitement médicamenteux), Radiographie, Résistance aux substances, Sujet âgé, Sédimentation du sang, Études de suivi.
- MESH :
- analyse : Facteur rhumatoïde, Hémoglobines, Immunoglobuline M.
- effets indésirables : Azathioprine, Cyclophosphamide, Hydroxychloroquine.
- imagerie diagnostique : Polyarthrite rhumatoïde.
- sang : Polyarthrite rhumatoïde.
- traitement médicamenteux : Polyarthrite rhumatoïde.
- usage thérapeutique : Azathioprine, Cyclophosphamide, Hydroxychloroquine.
- Adulte, Adulte d'âge moyen, Association de médicaments, Femelle, Humains, Mâle, Numération des leucocytes, Polyarthrite rhumatoïde, Radiographie, Résistance aux substances, Sujet âgé, Sédimentation du sang, Études de suivi.
English descriptors
- KwdEn :
- Adult, Aged, Arthritis, Rheumatoid (blood), Arthritis, Rheumatoid (complications), Arthritis, Rheumatoid (diagnostic imaging), Arthritis, Rheumatoid (drug therapy), Azathioprine (adverse effects), Azathioprine (therapeutic use), Blood Sedimentation, Cyclophosphamide (adverse effects), Cyclophosphamide (therapeutic use), Drug Resistance, Drug Therapy, Combination, Female, Follow-Up Studies, Hemoglobins (analysis), Humans, Hydroxychloroquine (adverse effects), Hydroxychloroquine (therapeutic use), Immunoglobulin M (analysis), Leukocyte Count, Male, Middle Aged, Radiography, Rheumatoid Factor (analysis).
- MESH :
- chemical , adverse effects : Azathioprine, Cyclophosphamide, Hydroxychloroquine.
- chemical , analysis : Hemoglobins, Immunoglobulin M, Rheumatoid Factor.
- blood : Arthritis, Rheumatoid.
- complications : Arthritis, Rheumatoid.
- diagnostic imaging : Arthritis, Rheumatoid.
- drug therapy : Arthritis, Rheumatoid.
- chemical , therapeutic use : Azathioprine, Cyclophosphamide, Hydroxychloroquine.
- Adult, Aged, Blood Sedimentation, Drug Resistance, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Leukocyte Count, Male, Middle Aged, Radiography.
Abstract
Cyclophosphamide, azathioprine, and hydroxychloroquine sulfate were prescribed for 31 patients (26 women and five men) with rheumatoid arthritis refractory to conventional therapy. Maintenance drug dosages (mean +/- SD) were as follows: cyclophosphamide, 30 +/- 24 mg/day; azathioprine, 74 +/- 44 mg/day; and hydroxychloroquine sulfate, 210 +/- 92 mg/day. Disease suppression began in 30 patients within three to 24 months (mean, nine months). Results after 43 months (range, 12 to 102 months) were as follows: 16, complete remission; seven, near remission; seven, partial disease suppression; one, no response. None remained in prolonged remission without some form of therapy. Treatment was discontinued in three patients because of pulmonary infection (two) or thrombocytopenia (one). Four patients had five malignant neoplasms (surgical cures) before therapy (two breast, one colon, one melanoma, one endometrial); four patients developed a malignant neoplasm during combined drug therapy (one colon, one endometrial, one lung, one erythroleukemia); and three died. The absolute risk of malignancy from combined drug therapy is still unclear. We concluded that combined use of remittive agents may have promise in treatment of severe rheumatoid arthritis; cyclophosphamide should be replaced with a nonalkylating agent; and the place of combined drug therapy remains uncertain in the absence of controlled trials.
PubMed: 3959321
Affiliations:
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Le document en format XML
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suivi</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Cyclophosphamide, azathioprine, and hydroxychloroquine sulfate were prescribed for 31 patients (26 women and five men) with rheumatoid arthritis refractory to conventional therapy. Maintenance drug dosages (mean +/- SD) were as follows: cyclophosphamide, 30 +/- 24 mg/day; azathioprine, 74 +/- 44 mg/day; and hydroxychloroquine sulfate, 210 +/- 92 mg/day. Disease suppression began in 30 patients within three to 24 months (mean, nine months). Results after 43 months (range, 12 to 102 months) were as follows: 16, complete remission; seven, near remission; seven, partial disease suppression; one, no response. None remained in prolonged remission without some form of therapy. Treatment was discontinued in three patients because of pulmonary infection (two) or thrombocytopenia (one). Four patients had five malignant neoplasms (surgical cures) before therapy (two breast, one colon, one melanoma, one endometrial); four patients developed a malignant neoplasm during combined drug therapy (one colon, one endometrial, one lung, one erythroleukemia); and three died. The absolute risk of malignancy from combined drug therapy is still unclear. We concluded that combined use of remittive agents may have promise in treatment of severe rheumatoid arthritis; cyclophosphamide should be replaced with a nonalkylating agent; and the place of combined drug therapy remains uncertain in the absence of controlled trials.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Carrera, G F" sort="Carrera, G F" uniqKey="Carrera G" first="G F" last="Carrera">G F Carrera</name><name sortKey="Csuka, M" sort="Csuka, M" uniqKey="Csuka M" first="M" last="Csuka">M. Csuka</name><name sortKey="Mccarty, D J" sort="Mccarty, D J" uniqKey="Mccarty D" first="D J" last="Mccarty">D J Mccarty</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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