Forty patients with Graves' ophthalmopathy stages III-V were divided into two groups in a random manner according to their year of birth. Group I received prednisone in decreasing dosage. Group II received prednisone at a comparable dosage and ciclosporin. Steroids were discontinued after 10 weeks in the two groups. In the patients of group II, ciclosporin was continued over 12 months. The therapeutic effect was assessed by an activity score based on subjective and objective symptoms (computerized tomography and sonography of the orbit, Hertel values, clinical findings). All signs of endocrine ophthalmopathy improved significantly in both groups (P less than 0.01 in group I; P less than 0.001 in group II). The improvement was significantly greater in group II (P less than 0.05) according to the predefined score. After corticosteroids were discontinued, inflammatory signs recurred in nine patients in group I and in one of group II. During the observation period of 12 months, relapses occurred in eight out of twenty patients in group I and in only one out of twenty in group II. Muscle thickness decreased in nine patients in group II, 6 months after beginning therapy. At this time, the results were not influenced in any of the twenty patients in group I. Microsomal antibodies decreased significantly (P less than 0.001) in the ciclosporin group, whereas no change was seen in the other group. Renal values rose within the normal range in group II. In this group, an infection with Klebsiella pneumoniae occurred in one patient after 4 months of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

We conducted a double-blind, randomized trial comparing azathioprine (AZA) and methotrexate (MTX) in the treatment of patients with rheumatoid arthritis in whom parenteral gold and/or D-penicillamine treatment had been unsuccessful. Patients were randomly assigned to receive either AZA (100 mg daily) or oral MTX (7.5 mg weekly). After 8 weeks, the dosage was increased depending on the clinical improvement. Sixty-four patients were followed up for 48 weeks (33

In RA patients, inherited intermediate TPMT activity seems predictive for the development of severe side effects of AZA. Clinicians should consider measuring TPMT prior to treatment initiation to improve the safety of AZA use. We hypothesize that GI intolerance may also be related to a thiopurine metabolic imbalance.

Die canine Leishmaniose gehört heute in der Schweiz und in Deutschland zu einer der am häufigsten diagnostizierten Reiseerkrankungen beim Hund. Ziel der Studie war es, praktische Empfehlungen hinsichtlich Therapie mit Allopurinol und Verlaufskontrollen in einem nicht endemischen Gebiet zu erarbeiten. Anhand von 31 importierten und reisebegleitenden Hunden mit Leishmania-Infektionen, wurde die Wirkung von Allopurinol (10-15 mg/kg 2x täglich, per os) bezüglich klinischer und labordiagnostischer Parameter beobachtet. Die Diagnose erfolgte mittels DNA-und/oder Antikörpernachweis. 22 Hunde zeigten klinische Zeichen (Hautveränderungen, Lahmheiten und Konditionsstörungen) und 9 Hunde waren asymptomatisch, zeigten aber labordiagnostische Veränderungen. Unter Therapie mit Allopurinol verschwand die Symptomatik bei 20 Hunden binnen 1-5 Monaten.