McCune W J, Friedman A W
University of Michigan Medical Center, Department of Internal Medicine, Ann Arbor 48109-0358.
Curr Opin Rheumatol. 1992 Jun;4(3):314-21. doi: 10.1097/00002281-199206000-00005.
The use of cyclophosphamide, chlorambucil, azathioprine, and 5-fluorouracil in managing rheumatic disease is reviewed. The major focus of recent studies has been the treatment of lupus or systemic vasculitis. Long-term studies of treatment of lupus nephritis have provided additional data regarding the efficacy of regimens containing cyclophosphamide and the predictive value of renal biopsies in determining outcome. Related studies of alkylating agents in idiopathic membranous nephritis suggest that they may have a role in severe disease. Studies of immunosuppression in severe systemic vasculitis are reviewed. Controlled studies have shown that pheresis is probably not effective in this illness and suggest that the addition of cyclophosphamide to prednisone improves the control of disease activity.
