Tratamiento con ciclosporina de la artritis reumatoídea refractaria / Treatment of refractory rheumatoid arthritis with cyclosporine

ABSTRACT

Cyclosporine may be useful in the treatment of rheumatoid arthritis refractory to other immunosupressive agents, in doses of less than 10 mg/kg/day to minimize its nephrotoxic potential, that is enhanced with prolonged use of concomitant administration of antiinflammatory drugs. We report 15 patients aged 50 ñ 12 years with erosive rheumatoid arthritis lasting 5 ñ 4 yeras and refractory to other immunosupressive 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 ñ 0.7 mg/kg/day during 7 ñ 4 months, improved; a 30 percent increase in creatinine was observed in 3, blood pressure raised in six and 2 bad hepatic toxicity. in the 6 patients that did not improve, the mean treatment lapse was 4 ñ 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