Concise report
Treatment with cyclosporin switching to hydroxychloroquine in
patients with rheumatoid arthritis
W-U Kima, Y-I Seoa, S-H Parka, W-K Leeb, S-K Leeb, S-I Paeka, C-S Choa, H-H Songc, H-Y Kima
a Centre for Rheumatic
Disease, Kang-Nam St Mary's Hospital, School of Medicine, The Catholic
University of Korea, Seoul, Republic of Korea, b Department of Rheumatology,
Yonsei University College of Medicine, Seoul, Republic of Korea, c Department of
Biostatistics, The Catholic University of Korea, Seoul, Republic of
Korea
Correspondence to: Dr H-Y Kim, Division of Rheumatology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Centre for Rheumatic Diseases in Kang-Nam St Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, Seoul, 137-040, Korea rheuma{at}cmc.cuk.ac.kr
Accepted for publication 3 October
2000
OBJECTIVE
To
investigate the therapeutic benefit of cyclosporin A (CSA) switching to
hydroxychloroquine (HCQ) in patients with rheumatoid arthritis (RA).
METHODSThirty four
patients with RA who displayed residual inflammation and disability
despite partial responses to prior maximal tolerated doses of
methotrexate, were included. All were treated with a staged
approach using CSA for 24 weeks to induce clinical improvement,
followed by HCQ for 16 weeks to maintain the improvement. Seven ACR
core set measures were evaluated every four to eight weeks.
RESULTSDuring a 40 week open trial, 27/34 patients completed the study. CSA treatment
significantly reduced the tender joints score, swollen joints score,
visual analogue pain scale, patient's or doctor's global assessment,
patient's self assessed disability, and C reactive protein. Compared
with the time of entry into the trial, patients who switched from CSA
to HCQ still possessed significantly lower levels of most variables,
determined at 28, 32, and 40 weeks. According to the ACR 20%
improvement definition, 15/27 (56%) patients had improved at 24 weeks
after CSA treatment, and 14/27 (52%) remained improved at 16 weeks
after the change to HCQ. Frequent side effects, such as hypertrichosis,
gastrointestinal trouble, and hypertension, were noted during CSA
treatment, but most of these disappeared after switching to HCQ. The
mean levels of blood pressure and serum creatinine were significantly
increased during CSA treatment, but returned to normal after changing
to HCQ.
CONCLUSIONSThe data
suggest that CSA switching to HCQ treatment may be an effective
strategy for patients with RA partially responding to methotrexate,
particularly those with toxicity due to CSA.
© 2001 by Annals of the Rheumatic Diseases
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Immunology (including allergy)
-
Connective tissue disease
-
Degenerative joint disease
-
Musculoskeletal syndromes
-
Rheumatoid arthritis
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
