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Titolo:
THERAPY FOR THE MAINTENANCE OF REMISSION IN 65 PATIENTS WITH GENERALIZED WEGENER GRANULOMATOSIS - METHOTREXATE VERSUS TRIMETHOPRIM SULFAMETHOXAZOLE/
Autore:
DEGROOT K; REINHOLDKELLER E; TATSIS E; PAULSEN J; HELLER M; NOLLE B; GROSS WL;
Indirizzi:
UNIV LUBECK,ABT KLIN RHEUMATOL,OSKAR ALEXANDER STR 26 D-24572 BAD BRAMSTEDT GERMANY BAD BRAMSTEDT GMBH,RHEUMAKLIN BAD BRAMSTEDT GERMANY CHRISTIAN ALBRECHTS UNIV KIEL KIEL GERMANY
Titolo Testata:
Arthritis and rheumatism
fascicolo: 12, volume: 39, anno: 1996,
pagine: 2052 - 2061
SICI:
0004-3591(1996)39:12<2052:TFTMOR>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
CYTOPLASMIC ANTIBODY TITER; RELAPSES; CYCLOPHOSPHAMIDE; CLASSIFICATION; ASSOCIATION; VASCULITIS; RESISTANT; ARTERITIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
32
Recensione:
Indirizzi per estratti:
Citazione:
K. Degroot et al., "THERAPY FOR THE MAINTENANCE OF REMISSION IN 65 PATIENTS WITH GENERALIZED WEGENER GRANULOMATOSIS - METHOTREXATE VERSUS TRIMETHOPRIM SULFAMETHOXAZOLE/", Arthritis and rheumatism, 39(12), 1996, pp. 2052-2061

Abstract

Objective. To compare the efficacy of low-dose intravenous (IV) methotrexate (MTX; 0.3 mg/kg once weekly), both with and without concomitant prednisone, versus daily oral trimethoprim/sulfamethoxazole (T/S; 160 mg of trimethoprim + 800 mg of sulfamethoxazole twice a day), with and without prednisone, in maintaining remission in patients with generalized Wegener's granulomatosis (WG). Methods. In this study, 65 patients with generalized WG whose disease had entered remission,vith cyclophosphamide (CYC) and prednisone therapy were started on one of the following remission-maintenance regimens: MTX alone (group A; n = 22), T/S alone (group B; n = 24), MTX plus concomitant prednisone (group C; n = 11), and T/S plus concomitant prednisone (group D; n = 8), Clinical, radiographic, and seroimmunologic data were evaluated to assess theefficacy of the 4 regimens and to seek possible predictive factors concerning outcome in each group. Results. Partial or complete remissionwas maintained in 86% of the patients in group A, but in only 58% of those in group B (P < 0.05), In group C, 91% of patients remained in remission, which is in sharp contrast to group D, in which all patientsexperienced a relapse after a median of 14.5 months (P < 0.005), Sideeffects occurred twice as often with MTX (n = 12) as with T/S (n = 6)treatment and could usually be resolved by supplemental folinic acid,Two patients taking MTX and 3 patients taking T/S were withdrawn fromthe study medication because of side effects, In none of the patientswere the adverse effects life threatening, No statistically significant factors predictive of poor outcome emerged in any group. Conclusion. Low-dose MTX was found to be superior to T/S for the safe and effective maintenance of remission in patients with generalized WG. The use of concomitant prednisone was not associated with a worse outcome withMTX treatment, Since T/S, especially with concomitant prednisone, seemed to increase the chance of relapse, neither T/S alone nor T/S plus prednisone can be recommended for the maintenance of remission in patients with generalized WG.

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Documento generato il 04/12/20 alle ore 01:31:04