The Use of Dapsone in the Treatment of Giant Cell Arteritis and Polymyalgia Rheumatica

Doury, P; Pattin, S; Eulry, F; Thabaut, A

doi:10.1002/art.1780260521

Cited by 28 publications

(11 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Reports on treatment of difficult-to-treat GCA with DDS are limited to an earlier report of 12 patients from our department and a further 4 cases. [21,23] Table 5 summarizes these previous studies. In the present study, at least 61% of the 38 assessable DDS-2 patients were able to significantly decrease their prednisone daily dose (from 23 ± 13.8 to 6.1 ± 6.0 mg/d; mean monthly decrease, 1.25 mg) while taking DDS, although this subset comprised a significant proportion of truly resistant patients.…”

Section: Discussionmentioning

confidence: 99%

“…[20] It has also been occasionally reported as a potent steroid-sparing agent in GCA, with the ability to reduce the cumulative prednisone dose and the total duration of treatment. [21–23] The steroid-sparing effect of DDS could be explained by several mechanisms, including oxygen-radical scavenging, reduction of tumor necrosis factor (TNF)-α and interleukin-8 micro RNA levels, and dysregulation of lymphocyte function in healthy volunteers. [17] In 1986, our department conducted a multicenter, nationwide, randomized study comparing prednisone alone to prednisone plus DDS in patients with newly diagnosed GCA.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis

Dalmay²,

Gondran³

et al. 2016

Medicine

View full text Add to dashboard Cite

Although a glucocorticoid (GC)-sparing strategy is needed for patients with giant cell arteritis (GCA) suffering from refractory disease or serious treatment-related complications, evidence of efficacy in this setting of immunosuppressive drugs and biotherapies is lacking. Herein, we evaluated the GC-sparing effects and tolerability of addition of dapsone (DDS) to prednisone therapy in patients with GCA. We retrospectively assessed data on 18 GCA patients who received DDS as a first-line treatment (DDS-1 group) and 52 patients who received it as a second- or third-line treatment for refractory GCA, with or without excessive GC-related toxicity (DDS-2 group). Of these 70 patients, 63 belonged to an inception cohort of 478 patients, whereas the remaining 7 were referred to our department for resistant GCA. In all, 52 patients were assessable for DDS efficacy. The baseline characteristics of the DDS-1 patients were similar to those of 395 GCA patients (control group) who received prednisone alone. DDS-1 patients had a more sustained decrease in GC dose with a lower mean prednisone dose at 12 months, and they comprised higher proportions who achieved GC withdrawal within the first year, who stopped prednisone treatment, and who recovered from GCA (P < 0.001 for each variable). Patients in the DDS-2 group achieved a mean rate of prednisone reduction of 65% and a prednisone dose reduction of 16.9 ± 13.3 mg/d. The monthly decreases in the prednisone dose were 2.4 and 1.25 mg in DDS-1 and DDS-2 patients, respectively. DDS-induced side effects were recorded in 44 (64%) assessable patients. These side effects led to lowering of the DDS dose by 25 mg/d in 11 (16%) patients and permanent cessation of DDS in 14 patients (20%), due to allergic skin rash in 7, agranulocytosis in 2, icteric hepatitis in 2, and excessive hemolysis in 2 patients. DDS is a potent GC-sparing agent in GCA that should be evaluated in prospective studies. However, DDS use should be restricted to refractory GCA patients due to its toxicity, and close clinical and laboratory monitoring for 3 months is necessary.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis

Dalmay²,

Gondran³

et al. 2016

Medicine

View full text Add to dashboard Cite

show abstract

“…De Silva and Hazelman [227], in a double-blind study, found that nzothioprine in doses of 50 to 150 nig/day can be steroid-sparing in patients with GCA. Two studies have suggested that dnpsone m;lsy be steroid-sparing in GG\ [228,229]. Krall and colleagues [230] found that lom-dose methotresate (7.5-12.5 mg/ week) proved to be steroid-sparing in 3 patients with steroid-resistant GGI.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Rheumatic Disease in the Intensive Care Unit: Acute Septic Arthritis and Giant-Cell Arteritis

Simms

Zerbini

1993

J Intensive Care Med

View full text Add to dashboard Cite

“…Reports on the use of dapsone (Dap) in PMR/TA are largely found in the French literature, with several brief uncontrolled case reports of successful outcomes [47][48][49][50]. One multicenter, randomized, controlled trial was begun to critically evaluate the value of dapsone in this population, but was terminated early because of a high percentage of patients incurring serious side effects [50].…”

Section: Dapsonementioning

confidence: 99%

Polymyalgia rheumatica/temporal arteritis: Recent advances

Barilla-LaBarca

Lenschow²,

Brasington

2002

Curr Rheumatol Rep

View full text Add to dashboard Cite

Polymyalgia rheumatica (PMR)/temporal arteritis (TA) frequently causes significant morbidity in patients older than 50 years of age. This review highlights recent trends in clinical findings, epidemiology, pathogenesis, and laboratory and radiologic assessment of the disease. Although steroids are the mainstay of therapy because of their effectiveness and ease of administration, they have numerous side effects, particularly in an aging population. Furthermore, recent evidence suggests that steroids only suppress clinical symptoms, while a smoldering level of damaging vascular inflammation persists. As a result, alternative agents are actively being investigated. We compare their successes and shortcomings and offer insight into their potential role in the treatment of this disease.

show abstract

The Use of Dapsone in the Treatment of Giant Cell Arteritis and Polymyalgia Rheumatica

Cited by 28 publications

References 3 publications

Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis

Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis

Rheumatic Disease in the Intensive Care Unit: Acute Septic Arthritis and Giant-Cell Arteritis

Polymyalgia rheumatica/temporal arteritis: Recent advances

Contact Info

Product

Resources

About