Document Detail


Intravenous cyclophosphamide therapy for progressive interstitial pneumonia in patients with polymyositis/dermatomyositis.
MedLine Citation:
PMID:  16754626     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To study the efficacy and safety of monthly intravenous pulse cyclophosphamide (IVCYC) therapy for progressive interstitial pneumonia in polymyositis/dermatomyositis (PM/DM). METHODS: Seventeen patients with PM/DM/amyopathic DM (mean age 51.4 +/- 10.4, mean follow-up 32 months) who received IVCYC for progressive interstitial pneumonia between August 1993 and October 2002 were studied. Nine patients had failed to respond to previous treatment with high-dose steroid and/or immunosuppressant. Cyclophosphamide (300-800 mg/m2) was given at least six times every 4 weeks. Oral prednisolone (0.5-1 mg/kg/day) was administered for the first 2 weeks and was gradually tapered. Response to treatment was evaluated based on the degree of exertional dyspnea, pulmonary function test and high-resolution computed tomography (HRCT). RESULTS: Eleven of 17 patients showed improvement in their dyspnea; six out of seven patients who had required oxygen treatment before IVCYC no longer did so after IVCYC. Eight of 17 patients had >or=10% improvement of vital capacity (VC)% and 9/17 had >or=10 point reduction in their HRCT score. Twelve patients had exhibited at least one result. Two patients with anti-Jo-1 antibodies showed a flare-up of interstitial pneumonia or myositis. After the IVCYC therapy, mean VC% improved by 15% (from 68 to 83%, P = 0.0034). The extent of abnormal lesions in HRCT was reduced from 24 to 13% (P = 0.0055). There was neither death nor severe toxicities observed. CONCLUSIONS: In this open-label study, IVCYC improved symptoms, pulmonary function tests and HRCT findings in patients with PM/DM. Longitudinal controlled studies are required to further confirm the efficacy of IVCYC.
Authors:
Y Yamasaki; H Yamada; M Yamasaki; M Ohkubo; K Azuma; S Matsuoka; Y Kurihara; H Osada; M Satoh; S Ozaki
Related Documents :
16145346 - Empiric therapy of autoimmune hepatitis with mycophenolate mofetil: comparison with con...
16125506 - Management, risk factors, and outcomes in recurrent pericarditis.
15198456 - Devic's neuromyelitis optica treated with intravenous gamma globulin (ivig).
12224976 - Corticosteroid-sparing effect of intravenous immunoglobulin therapy in patients with pe...
16600226 - Urinary follicle-stimulating hormone (fsh) is more effective than recombinant fsh in ol...
15502566 - Remodeling of the proximal femur after upper femoral varus osteotomy for the treatment ...
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2006-06-04
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  46     ISSN:  1462-0324     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-13     Completed Date:  2007-03-30     Revised Date:  2007-09-06    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  124-30     Citation Subset:  AIM; IM    
Affiliation:
Division of Rheumatology and Allergy, Department of Medicine, St Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa 216-8511, Japan. yams@marianna-u.ac.jp
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cyclophosphamide / administration & dosage,  adverse effects,  therapeutic use*
Dermatomyositis / complications
Disease Progression
Drug Administration Schedule
Dyspnea / drug therapy,  etiology
Humans
Immunosuppressive Agents / administration & dosage,  adverse effects,  therapeutic use*
Injections, Intravenous
Lung Diseases, Interstitial / drug therapy*,  etiology,  physiopathology,  radiography
Middle Aged
Polymyositis / complications*
Tomography, X-Ray Computed
Treatment Outcome
Vital Capacity / drug effects
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 50-18-0/Cyclophosphamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Robotics and telesurgery--an update on their position in laparoscopic radical prostatectomy.
Next Document:  Ages of onset suggestive of genetic anticipation in rheumatoid arthritis multicase sibships can be e...