RESUMO
OBJECTIVE: To define clinical and laboratory outcomes of longterm recombinant interferon-gamma (rIFN-gamma) treatment of patients with rheumatoid arthritis (RA). METHODS: Patients with RA (70) completing a 12-week multicenter double blind trial comparing rIFN-gamma with placebo were enrolled in a longterm prospective protocol evaluating rIFN-gamma in RA. RESULTS: The majority of patients sustained clinical improvement for one year. Eight (11%) patients with RA continued to receive rIFN-gamma after 5 years. One patient fulfilled remission criteria. rIFN-gamma was well tolerated with remarkably few suspected adverse drug reactions. Forty-seven (67%) patients discontinued rIFN-gamma because of lack of efficacy, 7 (10%) because of concurrent illnesses, 5 (7%) were not compliant to study protocol, 3 (4%) developed suspected adverse drug reactions for a total of 62 (89%) withdrawals over the 5 years of followup. Patients continuing rIFN-gamma treatment for 5 years had lower initial total leukocyte and neutrophil counts and higher hemoglobin and hematocrit levels than patients who discontinued rIFN-gamma during the 5-year followup. CONCLUSIONS: Longterm treatment of RA with rIFN-gamma was generally well tolerated. Although many patients maintained sustained clinical improvement for at least one year, the main reason for discontinuing the drug over 5 years was the lack of continued benefit.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/epidemiologia , Interferon gama/uso terapêutico , Artrite Reumatoide/diagnóstico por imagem , Artrografia , Método Duplo-Cego , Seguimentos , Nível de Saúde , Humanos , Interferon gama/efeitos adversos , Articulações/patologia , Estudos Prospectivos , Proteínas Recombinantes , Fatores de TempoAssuntos
Corticosteroides/administração & dosagem , Sulfassalazina/administração & dosagem , Urticária/tratamento farmacológico , Corticosteroides/efeitos adversos , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Transtornos Relacionados ao Uso de SubstânciasRESUMO
Seventy patients with rheumatoid arthritis (RA) completing a 12-week multicenter double blind trial comparing recombinant human interferon-gamma (r-IFN-gamma) with placebo were enrolled in a longterm prospective protocol evaluating r-IFN-gamma in RA. Forty (57%) patients after 1 year and 26 (37%) patients after 2 years continued the drug with sustained clinical benefit. Over 2 years, r-IFN-gamma was discontinued in 44 patients (lack of efficacy--25, withdrawn consent--7, noncompliant--4, suspected adverse drug reactions--2, concurrent illness--6). Two years of treatment with r-IFN-gamma were well tolerated with sustained clinical benefit in some patients with few significant adverse drug reactions.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Interferon gama/uso terapêutico , Artrite Reumatoide/sangue , Artrite Reumatoide/fisiopatologia , Contagem de Células Sanguíneas , Seguimentos , Humanos , Interferon gama/efeitos adversos , Articulações/fisiopatologia , Dor , Estudos Prospectivos , Proteínas RecombinantesRESUMO
One hundred five patients were enrolled in a 12-week, randomized, prospective, double-blind, placebo-controlled trial of recombinant human gamma-interferon (rHu gamma-IFN) for the treatment of rheumatoid arthritis. Fifty-four patients received rHu gamma-IFN and 51 received placebo. Forty-two patients in each group completed the 12-week trial. Some clinical improvement occurred in both groups of patients. Although the improvement with rHu gamma-IFN was greater than that with placebo, the differences were generally not statistically significant.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Interferon gama/uso terapêutico , Placebos/uso terapêutico , Adulto , Idoso , Antígenos de Superfície/metabolismo , Artrite Reumatoide/imunologia , Artrite Reumatoide/metabolismo , Ensaios Clínicos como Assunto , Método Duplo-Cego , Tolerância a Medicamentos , Feminino , Humanos , Interferon gama/efeitos adversos , Leucócitos/imunologia , Leucócitos/metabolismo , Masculino , Proteínas de Membrana/metabolismo , Pessoa de Meia-Idade , Proteínas Recombinantes , Fatores de TempoRESUMO
Two patients with profound decrease of alpha1-antitrypsin (PiZZ) presented with severe pannicultis (Weber-Christian disease); one had systemic panniculitis including pancreatitis. Another possible case is quoted from the literature. Although milder forms of panniculitis can have normal Pi phenotypes and alpha1-antitrypsin levels, the marked reduction of antiproteolytic activity found in PiZZ homozygotes may predispose to or aggravate the lesions of Weber-Christian disease.
Assuntos
Paniculite Nodular não Supurativa/complicações , Deficiência de alfa 1-Antitripsina , Adulto , Transtornos das Proteínas Sanguíneas/complicações , Humanos , Masculino , Pancreatite/complicações , FenótipoRESUMO
Three patients developed an acute hemarthrosis related to sodium warfarin. Synovial aspiration was well tolerated and necessary to substantiate the diagnosis. Prior joint disease was present in two but in only one was there a definite precipitating event, namely minor trauma. The prothrombin time was within the therapeutic range in two of the three. The acute synovitis subsided after the warfarin was discontinued. Joint function seems to have fully returned but long-term evaluation is needed.
