Massardo L, Jacobelli S, Figueroa F, Gutiérrez F, Martínez M E, Rivero S
Departamento de Reumatología e Inmunología Clínica, Escuela de Medicina, P Universidad Católica de Chile, Santiago de Chile.
Rev Med Chil. 1995 Feb;123(2):215-24.
Cyclosporine may be useful in the treatment of rheumatoid arthritis refractory to other immunosuppressive agents, in doses of less than 10 mg/kg/day to minimize its nephrotoxic potential, that is enhanced with prolonged use or concomitant administration of anti-inflammatory drugs. We report 15 patients aged 50 +/- 12 years with erosive rheumatoid arthritis lasting 5 +/- 4 years and refractory to other immunosuppressive agents. They were studied during one year and received cyclosporine in initial doses of 2.5 mg/kg/day that were increased to 5 mg/kg/day, assessing clinical response, blood pressure and serum creatinine. Nine patients, that received a maximal dose of 3.4 +/- 0.7 mg/kg/day during 7 +/- 4 months, improved; a 30% increase in creatinine was observed in 3, blood pressure raised in six and two had hepatic toxicity. In the six patients that did not improve, the mean treatment lapse was 4 +/- 3 months and the maximal dose achieved was 2.7 mg/kg/day; creatinine increased in one and blood pressure increased in 4. It is concluded that although the clinical response to cyclosporine was good, only 4 patients completed one year of treatment, due to the frequent secondary effects of the drug.
环孢素可用于治疗对其他免疫抑制剂难治的类风湿性关节炎，剂量小于10毫克/千克/天，以尽量降低其肾毒性，长期使用或同时服用抗炎药会增强这种毒性。我们报告了15例年龄为50±12岁的患者，患有侵蚀性类风湿性关节炎，病程为5±4年，对其他免疫抑制剂难治。对他们进行了为期一年的研究，初始剂量为2.5毫克/千克/天的环孢素，后增至5毫克/千克/天，评估临床反应、血压和血清肌酐。9例患者在7±4个月内接受了最大剂量为3.4±0.7毫克/千克/天的治疗，病情有所改善；3例患者肌酐升高30%，6例患者血压升高，2例患者出现肝毒性。6例未改善的患者，平均治疗时间为4±3个月，达到的最大剂量为2.7毫克/千克/天；1例患者肌酐升高，4例患者血压升高。得出的结论是，尽管环孢素的临床反应良好，但由于该药频繁出现副作用，只有4例患者完成了一年的治疗。
