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Titolo:
The effectiveness and toxicity of cyclosporin A in rheumatoid arthritis: Longitudinal analysis of a population-based registry
Autore:
Marra, CA; Esdaile, JM; Guh, D; Fisher, JH; Chalmers, A; Anis, AH;
Indirizzi:
Univ British Columbia, Fac Med, Dept Hlth Care & Epidemiol, Vancouver, BC V5Z 1M9, Canada Univ British Columbia Vancouver BC Canada V5Z 1M9 ver, BC V5Z 1M9, Canada St Pauls Hosp, Ctr Hlth Evaluat & Outcomes Sci, Vancouver, BC V6Z 1Y6, Canada St Pauls Hosp Vancouver BC Canada V6Z 1Y6 , Vancouver, BC V6Z 1Y6, Canada Univ British Columbia, Dept Med, Div Rheumatol, Vancouver, BC V5Z 1M9, Canada Univ British Columbia Vancouver BC Canada V5Z 1M9 ver, BC V5Z 1M9, Canada Arthrit Res Ctr, Vancouver, BC, Canada Arthrit Res Ctr Vancouver BC Canada thrit Res Ctr, Vancouver, BC, Canada
Titolo Testata:
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
fascicolo: 3, volume: 45, anno: 2001,
pagine: 240 - 245
SICI:
0004-3591(200106)45:3<240:TEATOC>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTIINFLAMMATORY DRUGS; TERM EFFICACY; METHOTREXATE; THERAPY; HYDROXYCHLOROQUINE; COMBINATION;
Keywords:
cyclosporin A; rheumatoid arthritis; pharmacoepidemiology;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Anis, AH Ctr Hlth Evaluat & Outcomes Sci, 620-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada Ctr Hlth Evaluat & Outcomes Sci 620-1081 Burrard St Vancouver BC Canada V6Z 1Y6
Citazione:
C.A. Marra et al., "The effectiveness and toxicity of cyclosporin A in rheumatoid arthritis: Longitudinal analysis of a population-based registry", ARTH RH ART, 45(3), 2001, pp. 240-245

Abstract

Objective, To determine factors associated with response or toxicity to cyclosporin A (CSA) in a population-based inception cohort with rheumatoid arthritis (RA). Methods. Prospectively collected longitudinal measures including tender joint count (JC), duration of morning stiffness (MS), systolic and diastolic blood pressure (SBP, DBP), and serum creatinine (SCr) were modeled using generalized estimating equations. Survival methods were used to estimate CSA continuation time and its determinants. Results. Of 133 patients (75% female, median RA duration 13 years), 37 discontinued CSA because of ineffectiveness (19) or because of toxicity (18) including increased SCr in 10, hypertension in 4, infections in 3, and gingival hyperplasia in 1. Patients remained on CSA a median of 75 months (95% confidence interval [Cl] 38-112). Those receiving concomitant methotrexate (MTX) were more than 4 times as likely to continue on CSA therapy (hazard ratio 0.22, 95% CI 0.10-0.94). A lower final JC was predicted by a longer CSAtreatment duration (relative risk [RR] 0.99 per month, 95% CI 0.98-0.99) and concomitant MTX therapy (RR 0.79, 95% Cl 0.63-0.99); decreased MS was predicted only by longer CSA treatment duration (reduction of 2.0 minutes permonth, 95% Cl 1.1-3.0). Each previous disease-modifying antirheumatic drug(DMARD) exposure predicted a rise in SCr (35 mu mole/liter, 95% CI 22-48),SBP (7.2 mm Hg, 95% CI 2.7-11.7), and DBP (3.8 nun Hg, 95% Cl 3.0-6.4). Conclusions. Combination CSA/MTX prolongs therapy and reduces JC. Long-term CSA treatment was fairly well tolerated. Previous DMARD use appears to bea determinant for the development of toxicity.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 21:34:13