Cyclosporin A in Severe, Treatment-Refractory Rheumatoid Arthritis

Abstract

Study objective: To assess the efficacy and toxicity of cyclosporin A in patients with severe, treatment-refractory rheumatoid arthritis. Design: Prospective randomized, double-blind 6-month trial. Patients: Thirty-one patients who had classic seropositive rheumatoid arthritis with active synovitis unresponsive to conventional therapy. Interventions: Patients were randomly assigned to high-dose (10 mg/kg body weight .cntdot. d) or low-dose (1 mg/kg .cntdot.d) cyclosporin A therapy.A reduction in the dose was permitted for adverse side effects. After 6 months of therapy, patients who showed clinically relevant improvement, defined as a 40% or greater reduction in their total joint activity score, were given the option to continue receiving the therapy for an additional 6 months.