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Deflazacort was administered at a mean starting dose of 21 8 mg/day with a range of 6-60 mg depending on severity of disease. The Results PATIENTSThe mean age of the 40 patients (24 women/ 16 men) was 70 7 years (range 50-91 years). Patients were referred 4-6 months after the onset of PMR on average (range 1-14 months).Twenty seven patients were allowed to continue treatment with NSAIDs at low doses. Of these, 15 received NSAIDs for less than three months and 12 for 9 7 months in average. The dose of NSAIDs in these 12 patients was constant throughout the study. FOLLOW UPTwo patients were lost to follow up on the first and third month. In the remaining 38 patients, the treatment lasted a mean of 18-9 months (range 9-48 months). Of the 23 patients with remission, seven required deflazacort for less than one year, and 20 for less than two years (fig 1). In these patients, the mean follow up after discontinuation of deflazacort was 9 9 months (range 1-33 months). The mean daily dose of deflazacort was 11-4 mg (range 2-5-32-2 mg) and the cumulative dose ranged between 0 9 g and 27 g (mean 6-6 g).Twenty three of 38 patients (60-5%) had no exacerbations; 13 patients had one exacerbation, 331 on 9 May 2018 by guest. Protected by copyright.

A. Haemopoietic stem and progenitor cells in the treatment of severe autoimmune diseases. Ann Rheum Dis 1996; 55:149-51. 2 Jacobs P, Vincent MD, Martell RW. Prolonged remission of severe refractory rheumatoid arthritis following allogenic bone marrow transplantation for drug induced aplastic anaemia.

The efficacy of different therapeutic regimens for Lyme arthritis is reviewed. The first treatment for Lyme arthritis, intramuscular benzathine penicillin 2.4 million units weekly for 3 weeks, had a success rate of 35%. Another study employed intravenous penicillin G at a dosage of 20 million units daily for 10 days, which cured 55% of patients. Intravenous ceftriaxone has been shown to be superior to penicillin with a response rate of 94%. However, these results have been challenged in recent reports. Oral doxycycline or amoxicillin in association with probenecid seems to work equally well although neuroborreliosis was more frequent following treatment with amoxicillin. An anecdotal report indicates the usefullness of long-term benzathine penicillin for chronic Lyme arthritis. Long-term antibiotic therapy, which is recommended also for Reiter's syndrome, may be useful for eradicating the sanctuaries of Borrelia burgdorferi. Disease-modifying drugs such as hydroxychloroquine or sulphasalazine, a drug which is commonly used in reactive arthritis following enteric infections, may be of value in Lyme arthritis resistant to antibiotics but have not been tested to date. The role of intraarticular injections of steroids or synovectomy is still controversial. Antibiotic treatment is the cornerstone of Lyme arthritis treatment. Additional interventions should be studied for patients with Lyme arthritis resistant to antibiotics.

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