Update on immunosuppressive therapy

Current Opinion in Rheumatology

Volumn 10, Issue 3, 1998, Pages 169-173

  Singer, Nora G ^a   McCune, W Joseph ^b  

^a Div Pediat Immunol Allerg R   (United States)

^b UNIVERSITY OF MICHIGAN   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AZATHIOPRINE; CLADRIBINE; CYCLOPHOSPHAMIDE; CYCLOSPORIN; HYDROXYCHLOROQUINE; IMMUNOSUPPRESSIVE AGENT; MEPREDNISONE; METHOTREXATE; SALAZOSULFAPYRIDINE; TACROLIMUS;

AUTOIMMUNE DISEASE; BEHCET DISEASE; BONE MARROW SUPPRESSION; HUMAN; INTRAVENOUS DRUG ADMINISTRATION; JUVENILE RHEUMATOID ARTHRITIS; LIVER FIBROSIS; LUNG INJURY; ORAL DRUG ADMINISTRATION; PRIORITY JOURNAL; RETINOPATHY; RHEUMATIC DISEASE; SHORT SURVEY; SYSTEMIC LUPUS ERYTHEMATOSUS; WEGENER GRANULOMATOSIS;

ADULT; ARTHRITIS, JUVENILE RHEUMATOID; AZATHIOPRINE; BEHCET SYNDROME; CHILD; CLADRIBINE; CYCLOPHOSPHAMIDE; CYCLOSPORINE; DRUG THERAPY, COMBINATION; HUMANS; HYDROXYCHLOROQUINE; IMMUNOSUPPRESSIVE AGENTS; LIVER; LUNG; LUPUS ERYTHEMATOSUS, SYSTEMIC; METHOTREXATE; PEMPHIGOID, BENIGN MUCOUS MEMBRANE; RETINA; TACROLIMUS; THALIDOMIDE; WEGENER GRANULOMATOSIS;

EID: 0031805335     PISSN: 10408711     EISSN: None     Source Type: Journal    
DOI: 10.1097/00002281-199805000-00003     Document Type: Short Survey

References (16)

1. Wallace CA, Sherry DD: Trial of intravenous pulse cyclophosphamide and methylprednisolone in the treatment of severe systemic-onset juvenile rheumatoid arthritis. Arthritis Rheum 1997, 40:1852-1855. Addition of pulse cyclophosphamide to other therapies including 1 mg/kg methotrexate was associated with reduced prednisone dose and improved growth in a small open trial.
2. O'dell JR, Haire CE, Erikson N, Drymalski W, Palmer W, Eckhoff PJ, Garwood V, Maloley P, Pharm D, Klassen L, et al.: Treatment of rheumatoid arthritis with methotrexate alone, sulfasalazine and hydroxychloroquine, or a combination of all three medications. N Engl J Med 1996, 334:1287-1291. "Combination therapy" of adult rheumatoid arthritis appears to be quite successful. The findings of this trial are widely applied in clinical practice. Disease control improved when hydroxychloroquine and asulfadine were added to methotrexate.
3. Haskes PJ, Balistreri WF, Bove KE, Ballard ET, Passo MH: The long-term effect of methotrexate therapy on the liver in patients with juvenile rheumatoid arthritis. Arthritis Rheum 1997, 40:2226-2234. Methotrexate hepatotoxicity in children appears to be comparable to that in adults.
4. Kremer JM, Alarcón GS, Weinblatt ME, Kaymakcian MV, Macaluso M, Cannon GW, Palmer WR, Sundy JS, St. Clair EW, Alexander RW et al.: Clinical, laboratory, radiographic, and histopathologic features of methotrexate-associated lung injury in patients with rheumatoid arthritis. Arthritis Rheum 1997, 40:1829-1837. Methotrexate-induced lung injury may have a long prodrome. Rechallenges have been associated with severe reactions in some patients, including death.
5. Levy GD, Munz SJ, Paschal J, Cohen HB, Pince KJ, Peterson T: Incidence of hydroxychloroquine retinopathy in 1,207 patients in a large multicenter outpatient practice. Arthritis Rheum 1997, 40:1482-1486. The incidence of hydroxychloroquine-related ocular toxicity in this study was low. The finding confirms previous suggestions that dosages greater than 7 mg/kg/d of body weight are associated with higher risk.
6. Pandya AG: Cicatricial pemphigoid successfully treated with pulse intravenous cyclophosphamide. Arch Dermatol 1997, 133:245-247. A case report of low-dose oral cyclophosphamide administered simultaneously with pulse, complicating interpretation.
7. Werth VP and Department of Dermatology, University of Pennsylvania Medical Center: Pulse intravenous cyclophosphamide for treatment of autoimmune blistering disease. Arch Dermatol 1997, 133:229-230. This article calls for trials of pulse versus oral cyclophosphamide in dermatologic diseases.
8. Guillevin L, Cordier JF, Lhote F, Cohen P, Jarrousse B, Royer I, Philippe L, Jacquot C, Bindi P, Bielefeld P et al.: A prospective, multicenter, randomized trial comparing steroids and pulse cyclophosphamide vs. steroids and oral cyclophosphamide in the treatment of generalized Wegener's granulomatosis. Arthritis Rheum 1997, 40:2187-2198. The outcomes of this trial were comparable, and mortality and infection rates were high. Pulse cyclophosphamide was begun every 3 weeks.
9. Hoffman GS: Treatment of Wegener's granulomatosis: time to change the standard of care? Arthritis Rheum 1997, 40:2099-2104. This article discusses different treatment regimens including combined methotrexate-cyclophosphamide-corticosteroids.
10. Caccavo D, Laganà B, Mitterhofer A, Feri G, Afeltra A, Amoroso A, Bonomo L: Long-term treatment of systemic lupus erythematosus with cyclosporin A. Arthritis Rheum 1997, 40:27-35. Cyclosporine provided modest benefits and was associated with reduced prednisone dosage.
11. Davis JC, Austin H, Boumpas K, Fleisher TA, Yarboro C, Larson A, Balow J, Klippel JH, Scott D: A pilot study of 2-chloro-2′-deoxyadenosine in the treatment of systemic lupus erythematosus-associated glomerulonephritis. Arthritis Rheum 1998, 41:335-343. This study looked at safety and tolerability of the immunosuppressive agent 2-chloro-2′-deoxyadenosine (2-CdA) in patients with systemic lupus erythematosus-associated glomerulonephritis. This agent has been used in treatment of B-cell neoplasms, acute myelocytic leukemia, and cutaneous B-cell lymphoma. Because 2-CdA is preferentially toxic to mononuclear cells, it may offer advantages for use in patients with autoimmune disease.
12. Hamuryudan V, Ozyazgan Y, Hizli N, Mat C, Yurdakul S, Tüzün Y, Senocak M, Yazici H: Azathioprine in Behcet's syndrome. Arthritis Rheum 1997, 40:769-774. Long-term treatment with azathioprine is effective. The role of corticosteroids is unclear.
13. Suzuki N, Kaneko S, Ichino M, Mihara S, Wakisaka S, Sakane T: In vivo mechanisms for the inhibition of T lymphocyte activation by long-term therapy with tacrolimus (FK-506). Arthritis Rheum 1997, 40:1157-1167. A review of proposed mechanisms of drug action and drug resistance.
14. Leipold G, Schütz E, Haas JP, Oellerich M: Azathioprine-induced severe pancytopenia due to a homozygous two-point mutation of the thiopurine methyltransferase gene in a patient with juvenile HLA-B27-associated spondyloarthritis. Arthritis Rheum 1997, 40:1896-1898.
15. Huizinga TW, Dijkmans BA, van der Velde EA, van de Pouw Draan TC, Verweij CL, Breedveld FC: An open study of pentoxyfylline and thalidomide as adjuvant therapy in the treatment of rheumatoid arthritis. Ann Rheum Dis 1996, 55:833-836.
16. Ramos A, Martínez-Taboacla VM, Fito C, Rodriguéz-Valverde V: Clostridium difficile-associated diarrhea in rheumatoid arthritis patients who are receiving therapy with low-dose chlorambucil. Arthritis Rheum 1997, 40:2090-2091.