Doury P, Fabresse F X, Pattin S, Eulry F, Celton H, Larroque P
Ann Med Interne (Paris). 1984;135(1):31-5.
The authors report 8 cases of Horton's disease and/or polymyalgia rheumatica treated with prednisone with an initially favourable result. However, the disease progressed despite relatively high dose steroid therapy, complications of which contraindicated increasing the dosage and even necessitated rapid withdrawal of steroids. The association of dapsone 100 mg/day orally had a rapid favourable effect in all 8 cases. However this treatment was well tolerated in only 3 patients and could only be continued in 4 out of the 8 cases. Manifestations of intolerance (methemoglobinaemia) rapidly regressed after withdrawal of dapsone but this was followed by another exacerbation of the disease, resulting in a therapeutic impasse. Despite the incidence of these iatrogenic complications, dapsone would appear to provide a therapeutic option in patients with Horton's disease and/or polymyalgia rheumatica resistant to high dose steroid therapy or in whom complications of steroid therapy impose a reduction in dosage or complete withdrawal of the drug.
作者报告了8例使用泼尼松治疗的霍顿病和/或风湿性多肌痛患者，初始效果良好。然而，尽管使用了相对高剂量的类固醇治疗，疾病仍进展，其并发症使得增加剂量成为禁忌，甚至需要迅速停用类固醇。口服100毫克/天氨苯砜在所有8例患者中均迅速产生良好效果。然而，只有3例患者对该治疗耐受性良好，8例中只有4例能够继续使用。停用氨苯砜后，不耐受表现（高铁血红蛋白血症）迅速消退，但随后疾病再次加重，导致治疗陷入僵局。尽管存在这些医源性并发症，但氨苯砜似乎为对高剂量类固醇治疗耐药或因类固醇治疗并发症而必须减少剂量或完全停药的霍顿病和/或风湿性多肌痛患者提供了一种治疗选择。
