RESUMO
OBJECTIVE: To assess the safety and effectiveness of leflunomide (LNF) using 100 mg/week in patients with rheumatoid arthritis (RA). METHODS: Patients who were clinically active using the American College of Rheumatology criteria for RA were enrolled. They received a loading dose of 100 mg of LFN for 3 days, followed by 100 mg of LFN weekly. Efficacy and adverse events (AE) were recorded. RESULTS: Fifty patients were enrolled; 46 (93.6%) were women with a mean age of 45.6 years (range: 24 to 83). Disease duration was 3.7 years (range: 0.5 to 12). Twenty patients (40.8%) had previously taken disease modifying antirheumatic drugs. Outcomes achieved after 24 weeks of treatment were as follows: ACR20 (74%), ACR50 (64%), and ACR70 (28%). Five patients were withdrawn due to AE: 2 due to urticaria, 2 patients had elevated liver enzymes, and one had thrombocytopenia. Six patients (12%) were lost to followup. No severe AE were seen. CONCLUSION: The results in our preliminary report indicate that using a 100 mg/week dose achieves a similar benefit to the LFN 20 mg/day treatment, and there were no severe AE. In addition, a single LFN weekly dose has better treatment compliance. A secondary important benefit is the reduction of the monthly cost of medication. Comparative and blind trials are necessary in order to confirm longterm improvement and benefits on this regimen.
Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Artrite Reumatoide/tratamento farmacológico , Isoxazóis/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/efeitos adversos , Feminino , Humanos , Isoxazóis/efeitos adversos , Leflunomida , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Antecedentes. La tos es el efecto secundario más frecuente de los inhibidores de enzima convertidora de angiotensina (IECA); el losartán es un bloqueador de los receptores de angiotensina II, y no tiene efecto en esta enzima, por lo que la tos es poco probable. Objetivo. Determinar la tolerancia y la eficacia del losartán en pacientes con tos inducida por IECA. Material y métodos. Ensayo clínico abierto, con el paciente como su propio control, adultos, no fumadores, con historia de tos inducida por IECA, se sometieron a lavado hasta desaparecer la tos; posteriomente recibieron losartán en una dosis; se determinó la tensión arterial y el pulso al recibir IECA y a 2, 4 y 8 semanas después; en cada visita se interrogó acerca de la tos. Se hicieron mediciones de laboratorio de seguridad. Resultados. Se estudiaron 18 pacientes con una edad media de 59 años (ñ 8.8 ds); 13 toleraron el fármaco (72.2 por ciento, IC 95 por ciento=70.05 a 74.35); cinco (27.8 por ciento) desarrollaron tos. La tensión arterial se mantuvo sin cambios durante las primeras cuatro semanas, la tensión sistólica mostró a la octava semana reducción de 13.5 mmHg (IC95 por ciento=1.63 a 12.4), y 8.16 mmHg en la octava semana (IC 95 por ciento=3.4 a 12.8). No hubo diferencia en los parámetros bioquímicos. Conclusiones. El losartán es bien tolerado en la mayoría de los pacientes con historia de tos secundaria a IECA, es seguro y eficaz en la reducción de la tensión arterial en estos pacientes