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Low-dose intravenous cyclophosphamide in systemic sclerosis: an open prospective efficacy study in patients with early diffuse disease.

AbstractOBJECTIVE:
To investigate the efficacy of a treatment with low-dose intravenous cyclophosphamide (CYC) and low-dose prednisone in early diffuse cutaneous systemic sclerosis (dcSSc).
METHODS:
Patients with dcSSc and a disease duration <24 months consecutively admitted to a tertiary centre underwent a prospective 1-year study. They were treated with i.v. CYC 500 mg/pulses, 10 mg prednisone equivalent, and supportive therapy. Modified Rodnan skin score (mRss), Health Assessment Questionnaire-Disability Index (HAQ-DI), forced vital capacity (FVC), and diffusing lung capacity for CO (DLCO) were assessed as outcome measures. In addition, the nine Medsger severity scale scores were evaluated.
RESULTS:
mRss and DLCO significantly improved at both 6 (p = 0.002 and 0.012, respectively) and 12 months (p = 0.002 and 0.003, respectively). HAQ-DI showed a nearly significant reduction at 12 months (p = 0.06). Medsger's severity scores also improved for general condition (p = 0.001), peripheral vascular (p = 0.05), skin (p = 0.02), joint/tendon (p = 0.001), muscle (p = 0.05), and lung (p = 0.02). No treatment interruption was needed.
CONCLUSIONS:
This preliminary study suggests a role for low-dose i.v. CYC in the treatment of early dcSSc. Controlled studies are warranted.
AuthorsG Valentini, C Paone, G La Montagna, I Chiarolanza, M Menegozzo, E Colutta, L Ruocco
JournalScandinavian journal of rheumatology (Scand J Rheumatol) 2006 Jan-Feb Vol. 35 Issue 1 Pg. 35-8 ISSN: 0300-9742 [Print] England
PMID16467039 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Antirheumatic Agents
  • Cyclophosphamide
  • Prednisone
Topics
  • Adult
  • Antirheumatic Agents (administration & dosage, therapeutic use)
  • Cyclophosphamide (administration & dosage, therapeutic use)
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Patient Selection
  • Prednisone (therapeutic use)
  • Scleroderma, Diffuse (drug therapy, immunology)
  • Scleroderma, Systemic (drug therapy, immunology)
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

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