[Use of cyclosporin A in patients with severe, active, treatment-resistant rheumatoid arthritis ]. / Uso de la ciclosporina A en pacientes con artritis reumatoide con actividad severa y resistentes al tratamiento.

BACKGROUND: Rheumatoid arthritis (RA) is a multisystemic and chronic disease whose etiology still remains to know. RA and their complications implicate a huge cost, calculated in 1% of total national internal product in US. OBJECTIVE: To evaluate the use of cyclosporine A in RA patients refractory to conventional treatment. MATERIAL AND METHODS: Several improvement variables were used, such as Ritchie index, modified Sharp radiological scale, functional status, HAQ index, analog scale of pain, and PCR. 13 female were included with a mean age of 44 years (range 30-50), with a mean of RA evolution of 6 years (range 0.5-22); each patient received an initial dosage of 2.5 mg/day by oral microemulsion of cyclosporine A, with increasing dosage of 0.5 mg/kg/day, adjusting by seric values of creatinine. RESULTS: RA patients were evaluated, initially and after three and six months. Data were analyzed using Mann-Whitney U and Kruskal Wallis tests. In three months evaluation there was an improvement in functional status (p = 0.009). In six months evaluation there was an improvement in painful joints (p = 0.006), functional status (p = 0.007) and general comfort sensation (p = 0.014). CONCLUSION: The cyclosporine use is considered an effective therapy, like disease modifier in RA refractory patients to conventional treatment in at least six months of the treatment.