The Safety of Intravenous Cyclophosphamide in the Treatment of Rheumatic Diseases

Woytala, Patryk; Morgiel, Ewa; Łuczak, Anna; Czesak-Woytala, Katarzyna; Wiland, Piotr

doi:10.17219/acem/28736

Cited by 11 publications

(4 citation statements)

References 27 publications

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“…It is known to be teratogenic, embryotoxic and can cause infertility, therefore, if possible, should be avoided in women of childbearing age [ 45 ]. In a study that examined 65 patients with rheumatic diseases who were treated with intravenous CYC, the adverse effects reported, in descending order, were: infections, nausea, vomiting, abdominal pain and pancytopenia [ 46 ].…”

Section: Treatmentmentioning

confidence: 99%

Anti-MDA5 Amyopathic Dermatomyositis—A Diagnostic and Therapeutic Challenge

Bobircă

Alexandru

Mușetescu

et al. 2022

Life

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Clinically amyopathic Dermatomyositis (CADM) is a rare subtype of idiopathic inflammatory myositis, associated with no muscular manifestations, which is more frequent in Asian women. Anti-melanoma differentiation-associated gene 5 (MDA5) antibodies are a recently discovered type of specific autoantibodies associated with myositis. The anti-MDA5 DM was initially described in Japan and later it was discovered that the target antigen was a protein implicated in the innate immune response against viruses, that is encoded by the melanoma differentiation-associated gene 5. Anti-MDA5 DM is characteristically associated with distinguished mucocutaneus and systemic manifestations, including skin ulcerations, palmar papules, arthritis, and interstitial-lung disease. Patients with anti-MDA5 positivity have a high risk of developing rapid progressive interstitial-lung disease (RP-ILD), with a poor outcome. As a result, despite high mortality, diagnosis is often delayed, necessitating increased awareness of this possible condition. Despite a severe course of lung disease and an increased mortality rate, there is currently no standard treatment. Recent insights based on observational studies and case reports support combined therapy with immunosuppressive drugs and corticotherapy, as soon as the symptoms appear. The aim of this paper is to describe anti-MDA5 DM, focusing on the recent literature about the unique clinical manifestations and therapeutic options, starting from a severe clinical case diagnosed in our Rheumatology Department.

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Section: Treatmentmentioning

confidence: 99%

Anti-MDA5 Amyopathic Dermatomyositis—A Diagnostic and Therapeutic Challenge

Bobircă

Alexandru

Mușetescu

et al. 2022

Life

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“…The frequency of infections—bacterial, herpes zoster, fungi, and some opportunistic infections (e.g., P. carinii), being the most reported—is about 37% [ 158 , 160 ]. The prevalence of infection is similar between IV CYC (39%) and oral (40%), the risk factors including leukocyte nadir ≤3000 cells, sequential CYC regimens, and combination with high-dose GC [ 161 ].…”

Section: Cyclophosphamide (Cyc)mentioning

confidence: 99%

Synthetic Pharmacotherapy for Systemic Lupus Erythematosus: Potential Mechanisms of Action, Efficacy, and Safety

et al. 2022

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The pharmacological treatment of systemic lupus erythematosus (SLE) aims to decrease disease activity, progression, systemic compromise, and mortality. Among the pharmacological alternatives, there are chemically synthesized drugs whose efficacy has been evaluated, but which have the potential to generate adverse events that may compromise adherence and response to treatment. Therapy selection and monitoring will depend on patient characteristics and the safety profile of each drug. The aim of this review is to provide a comprehensive understanding of the most important synthetic drugs used in the treatment of SLE, including the current treatment options (mycophenolate mofetil, azathioprine, and cyclophosphamide), review their mechanism of action, efficacy, safety, and, most importantly, provide monitoring parameters that should be considered while the patient is receiving the pharmacotherapy.

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“…In a retrospective study in 65 patients treated with intravenous pulses for various autoimmune diseases, 60% experienced side effects, with no association between the frequency of side effects on treatment duration, age, diagnosis, or dose reduction. 39 Of note is that in the SLS II, 44% of the patients randomized in the cyclophosphamide arm discontinued prematurely due to side effects. 20 In a retrospective trial in 75 patients treated with intravenous cyclophosphamide for SSc-ILD, adverse events occurred in 23% of the cases, consisting of pneumonia, anemia, leucopenia, hematuria, renal insufficiency, and allergic exanthema.…”

Section: Side Effects Of Cyclophosphamidementioning

confidence: 99%

Is there still a role for cyclophosphamide in the treatment of systemic sclerosis?

Vonk

2020

Journal of Scleroderma and Related Disorders

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Cyclophosphamide has been the cornerstone of treatment of systemic sclerosis for a long time and is the first-choice therapy for treating systemic sclerosis–associated interstitial lung disease according to the European League Against Rheumatism recommendations on treatment of systemic sclerosis. However, new therapeutic options are emerging, and treatment with cyclophosphamide is hampered by its toxicity and restricted possible treatment duration. This review has a focus on the evidence of efficacy of cyclophosphamide in different aspects of systemic sclerosis and its organ involvements, reviews its toxicity, and will answer the question whether there is still a role for cyclophosphamide in the treatment of systemic sclerosis, taking the evidence and current therapeutic options into account.

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The Safety of Intravenous Cyclophosphamide in the Treatment of Rheumatic Diseases

Cited by 11 publications

References 27 publications

Anti-MDA5 Amyopathic Dermatomyositis—A Diagnostic and Therapeutic Challenge

Anti-MDA5 Amyopathic Dermatomyositis—A Diagnostic and Therapeutic Challenge

Synthetic Pharmacotherapy for Systemic Lupus Erythematosus: Potential Mechanisms of Action, Efficacy, and Safety

Is there still a role for cyclophosphamide in the treatment of systemic sclerosis?

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