Arif Moten.
Combination treatment of severe Rheumatoid Arthritis with Methotrexate & Cyclosporine for 36 weeks in patients refractory to other treatment.
Med Channel Jan ;10(2):59-62.

OBJECTIVE: To determine whether the combination of cyclosporine is effective in controlling the progression of disease, preventing further Joint damage and in bringing about remission in pain, swelling & improvement in movements. METHODS: Patients included in this study were patients who were referred with established R.A. of 2-10 yrs standing & who did not respond treatment with classical NSAIDS, Salazopyrin, & Chloroquin. Patients received MTX & CYA for 36 weeks & then followed up without any for further 26 weeks. The primary outcome was measured by the number of Joints involved, tenderness, swelling, pain, functional ESR, C-Reactive protein & radiological assessment. RESULTS: Results of the 23 patients so far studied 21 completed the study are still being followed. 2 pts dropped out of the study. There were 14 females & 7 males. Youngest was 14yrs & the oldest was 68 yrs. Average age was 48 yrs. Improvement started within 7-10 days & peak improvement was seen in 3-4 weeks. Improvement persisted for 36 weeks & maintained for further 26 weeks there after. Treatment had to he suspended for one week in 2 patients because of inter-current illness (common cold & flu). Conclusion: Clinical & radiological improvement obtained by use of MTX and CYA has been remarkable.

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