Report of a three‐year study on the systemic and articular indexes in rheumatoid arthritis

Twenty-four patients with severe progressive rheumatoid arthritis were randomly assigned to cyclophosphamide or placebo in a double-blind crossover trial.Eleven patients who completed 9 months on cycloplosphamide (average dose: 1.8 mg/ kg/day) demonstrated significant decrease in painful joints, swollen joints, and moroing stiffness and increase in grip strength when compared to 11 patients on placebo. After crossover, significant improvement was observed in patients switched to cyclophosphamide, and deterioration within 2 months was observed in most patients changed from drug to placebo. Serum immunoglobulins and rheumatoid factor titers decreased with cyclophosphamide but antibody response to Vi antigen was unaffected. Primary delayed immune response to 2,4-dinitrochlorobenzene was markedly depressed. Adverse effects were troublesomehemorrhagic cystitis affected 4 patients and amenorrhea occurred in 3. Despite its striking beneficial effect, cyclophosphamide

Section: Measures Of Disease Activitymentioning

confidence: 84%

Controlled trial of cyclophosphamide in rheumatoid arthritis

Townes

Sowa

Shulman

1976

“…All OA and RA patients were diagnosed and classified according to the criteria of the American Rheumatism Association (14,151. Total joint scores were computed according to the method of Lansbury (16). Disease duration was calculated from the date of the first appearance of symptoms.…”

Section: Methodsmentioning

confidence: 99%

Serum keratan sulfate. Quantitative and qualitative comparisons in inflammatory versus noninflammatory arthritides

Mehraban

Finegan

Moskowitz

1991

The concentration of keratan sulfate (KS) epitope was measured in the serum of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) by enzyme-linked immunosorbent assay and compared with that in the serum of patients with primary fibromyalgia syndrome (PFS) and of controls who had no joint disease. By Student's t-test, the mean serum KS concentrations in OA and RA patients measured with monoclonal antibodies (MAb) 5-D-4 and 2-D-3 were significantly increased over those in the PFS and normal groups; similar findings were observed using a nonparametric test, except that levels in RA patients showed no difference from those in PFS patients and normal subjects.There was no significant correlation between joint scores or disease duration and KS levels in OA or RA patients. Gel filtration of sera revealed mainly large, polydisperse KS-bearing fragments which eluted in a broad profile. KS purified from sera by immunoaffinity chromatography consisted mainly of high-density proteoglycans. Electrophoresis of pooled high-density KS fractions in polyacrylamfde-agarose gels followed by Western blotting with MAb 5-D-4 showed diffuse bands with relative mobilities corresponding to large proteoglycans. These findings are consistent with attachment of KS to protein core fragments of various sizes; KS in patient sera is comparable in size with that in normal sera. Elevations

“…Ninety patients received 100 mg capsules (M-group) and 89 were on 5 mg capsules as controls (C-group). At the onset a comparison of patients in the two groups revealed that they were balanced in most important respects, such as age, sex, body weight, in-or outpatients, duration of illness, each item of criteria for diagnosis of RA, stage, functional class, serum rheumatoid factor, coadministered drugs, rheumatoid activity index according to Lansbury (14) and severity of each item assessed by the Seven Day Variability Test of ARA (Table I).…”

Section: Patientsmentioning

confidence: 99%

“…The results disclosed that Lansbury's rheumatoid activity index of patients, assessed by duration of morning stiffness, grip strength, number of clinically active joints, and value of erythrocyte sedimentation rate (ESR) in 1 hour (14), reduced almost linearly within t h e first 4 m o n t h s of medication. Moreover, in 49 o f 168 patients (29%), positive serum rheumatoid factor became negative after treatment.…”

mentioning

confidence: 99%

Clinical evaluation of D‐penicillamine by multicentric double‐blind comparative study in chronic rheumatoid arthritis

Shiokawa

Horiuchi

Honma

et al. 1977

In order to evaluate clinical efficacy of D-penicillamine (DP) a double-blind study was conducted by the Metalcaptase Research Croup consisting of forty-one rheumatological centers in Japan. A total of 179 patients with rheumatoid arthritis (RA) was divided into two groups; one treated with 5 mg (control group) and the other with 100 mg (drug group) of DP in capsule form. The trial lasted 24 weeks. Global judgment by physicians revealed that improvement was found in 27% in the controls and 65% in the drug group. Adverse reactions occurred in 34% of the controls and 49% of the drug group. Skin rashes, taste disturbances, gastrointestinal upset and proteinuria were frequent in the drug group, but severe or fatal reactions could not be seen in this trial.