Document Detail

An open study of pentoxyfylline and thalidomide as adjuvant therapy in the treatment of rheumatoid arthritis.
MedLine Citation:
PMID:  8976641     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Dysregulation of tumour necrosis factor alpha (TNF alpha) production is thought to be important in rheumatoid arthritis. Since pentoxifylline and thalidomide inhibit endotoxin induced TNF production in vitro, these drugs were tested in an open study in rheumatoid arthritis patients to assess toxicity, the effect on TNF production, and the antiarthritic effects. METHODS: 12 patients with active rheumatoid arthritis were treated with 1200 mg pentoxifylline and 100 mg thalidomide a day during 12 weeks. In addition, TNF production was assessed by ex vivo whole blood cultures stimulated with endotoxin. RESULTS: Adverse events such as xerostomia, drowsiness, and constipation occurred in almost all patients, which led to discontinuation in three. The drugs halved the TNF production capacity during treatment (ANOVA, P < 0.03) whereas production capacity of interleukin (IL) 6, IL-10, and IL-12 was not affected. Of the nine patients who completed the study, five fulfilled the ACR-20% response criteria after 12 weeks of treatment. CONCLUSIONS: Although pentoxifylline/thalidomide reduced the production capacity of TNF, the benefit/side effects ratio was poor due to multiple adverse effects, while clinical observation suggests limited efficacy.
T W Huizinga; B A Dijkmans; E A van der Velde; T C van de Pouw Kraan; C L Verweij; F C Breedveld
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  55     ISSN:  0003-4967     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-01-09     Completed Date:  1997-01-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  833-6     Citation Subset:  IM; X    
Department of Rheumatology, University Hospital Leiden, The Netherlands.
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MeSH Terms
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / drug therapy*,  metabolism
Chemotherapy, Adjuvant
Hematologic Tests
Immunosuppressive Agents / therapeutic use*
Interleukin-10 / blood
Interleukin-12 / blood
Interleukin-6 / blood
Middle Aged
Pentoxifylline / adverse effects,  therapeutic use*
Severity of Illness Index
Thalidomide / adverse effects,  therapeutic use*
Tumor Necrosis Factor-alpha / drug effects
Reg. No./Substance:
0/Antirheumatic Agents; 0/Immunosuppressive Agents; 0/Interleukin-6; 0/Tumor Necrosis Factor-alpha; 130068-27-8/Interleukin-10; 187348-17-0/Interleukin-12; 50-35-1/Thalidomide; 6493-05-6/Pentoxifylline

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