Abstract | OBJECTIVES: METHODS: Retrospective chart analyses of 51 WG-patients with non-life-threatening relapses under MTX or LEF maintenance monotherapy. Relapsing patients were subsequently treated with a combination therapy of MTX+LEF. RESULTS: Fifty-one WG patients with relapses under MTX (n=36) or LEF (n=15) maintenance monotherapy were identified. They were subsequently treated with MTX+LEF to reintroduce remission. Mean follow-up was 26.0 (3-93) months. MTX+LEF controlled relapsing WG in 43/51 (84%) patients: 28/51 achieved a Birmingham Vasculitis activity index (BVAS)=0 and 15/51 a response (BVAS reduction of > = or). 8/51 patients did not respond to MTX+LEF (<50% BVAS reduction) and were switched to cyclophosphamide and/or a biological for ongoing disease activity. Follow up showed a sustained remission (BVAS=0 >3 months) in 14/51 patients, a minor relapse in 27/51, and a major relapse in 2/51 (subsequently switched to cyclophosphamide). Fifty adverse effects were observed. MTX+LEF therapy was discontinued in 18/51 patients because of adverse effects (main causes: gastro-intestinal complaints, hypertension, infections). CONCLUSIONS: Although side effects limited the overall performance of MTX+LEF, this combination, if tolerated well, remains an effective treatment in patients not warranting cyclophosphamide.
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Authors | Jan P Bremer, Sebastian Ullrich, Martin Laudien, Wolfgang L Gross, Peter Lamprecht |
Journal | Clinical and experimental rheumatology
(Clin Exp Rheumatol)
2010 Jan-Feb
Vol. 28
Issue 1 Suppl 57
Pg. 67-71
ISSN: 0392-856X [Print] Italy |
PMID | 20412706
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Inflammatory Agents, Non-Steroidal
- Immunosuppressive Agents
- Isoxazoles
- Leflunomide
- Methotrexate
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Topics |
- Adolescent
- Adult
- Aged
- Anti-Inflammatory Agents, Non-Steroidal
(administration & dosage, adverse effects)
- Drug Therapy, Combination
- Female
- Granulomatosis with Polyangiitis
(drug therapy, immunology)
- Humans
- Immunosuppressive Agents
(administration & dosage, adverse effects)
- Isoxazoles
(administration & dosage, adverse effects)
- Leflunomide
- Male
- Methotrexate
(administration & dosage, adverse effects)
- Middle Aged
- Remission Induction
- Retrospective Studies
- Secondary Prevention
- Young Adult
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