Bijlsma J W, Schenk Y, Ramselaar A C, Huber-Bruning O
Clin Rheumatol. 1986 Dec;5(4):499-504.
In the management of rheumatoid arthritis two potentially useful roles for methylprednisolone (MP) pulse therapy are presently recognised: in patients in whom second line drugs have not led to a satisfactory remission or have caused side effects, and in bridging the gap between the start and the delayed onset of effect of a slow-acting antirheumatic drug. Recently it was shown that MP-pulse therapy was effective in accelerating the response to sulphasalazine and D-penicillamine. Nineteen patients with a persistently active rheumatoid arthritis, who had failed to respond to at least two slow-acting antirheumatic drugs, were treated with MP-pulse therapy in conjunction with azathioprine. Twelve patients continued this treatment for 6 months and 8 for 12 months. MP-pulse therapy resulted in an immediate improvement in Ritchie articular index, grip strength, ESR and CRP. However, this improvement lasted less than six weeks. After 6 months some improvement due to the effect of azathioprine became apparent. Some rather serious side effects were noted. It is concluded that MP-pulse therapy has a (short lasting) beneficial effect in persistently active rheumatoid arthritis. However MP-pulse therapy is not suitable to bridge the gap between the introduction of azathioprine-treatment and the delayed response to this drug.
在类风湿性关节炎的治疗中，目前已认识到甲基强的松龙（MP）脉冲疗法有两个潜在的有益作用：对于二线药物未能带来满意缓解或已引起副作用的患者，以及在填补慢作用抗风湿药物开始使用与延迟起效之间的空白方面。最近有研究表明，MP脉冲疗法在加速对柳氮磺胺吡啶和青霉胺的反应方面是有效的。19例持续性活动性类风湿性关节炎患者，至少对两种慢作用抗风湿药物无反应，接受了MP脉冲疗法联合硫唑嘌呤治疗。12例患者持续该治疗6个月，8例持续12个月。MP脉冲疗法使里奇关节指数、握力、血沉（ESR）和C反应蛋白（CRP）立即得到改善。然而，这种改善持续不到六周。6个月后，由于硫唑嘌呤的作用，一些改善变得明显。还注意到了一些相当严重的副作用。得出的结论是，MP脉冲疗法对持续性活动性类风湿性关节炎有（短期）有益作用。然而，MP脉冲疗法不适用于填补引入硫唑嘌呤治疗与该药物延迟反应之间的空白。
