Efficacy of cyclosporin: a in refractory rheumatoid arthritis

ABSTRACT

The aim of the study was to evaluate the efficacy of cyclosporin-A in patients of rheumatoid arthritis not responding to standard therapy early in the course of the disease. Design: A non-randomized controlled clinical trial. Place and Duration of Study Outpatients Department of Abbasi Shaheed Hospital and Imam Clinic over a period of 18 months from March 1999 through September 2000. Materials and The study was carried out on 63 patients of both gender suffering with refractory rheumatoid arthritis for at least 3 months. Patients were divided into two groups A and B. Group-A was the experimental one, treated with cyclosporin-A in combination with methotrexate while Group-B was continued with methotrexate alone. Their pre and post assessments regarding recovery criteria and drug profile had been done in order to establish the efficacy of cyclosporin-A. The study showed a significant difference [p<.000 with a.05] after six months between treatment group and the controls, in the mean values of articular index [2.53 vs. 5.39], right grip [14.28 vs. 33.8 mmHg], left grip strengths [16.5 vs. 34.31 mmHg] and number of tender joints [26.9% vs. 38.6%]. Furthermore, a significant negative correlation between articular index at recruitment and visual analogue scale [VAS] of pain after 6 months of therapy was observed in experimental group. This study indicates that the combination of cyclosporin with methotrexate benefits rheumatoid arthritis patients refractory to methotrexate monotherapy. Cyclosporin was well tolerated by those having shorter duration of disease