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CYTOTOXIC THERAPY IN RHEUMATOID DISEASE
Author(s) -
Thorpe Peter,
Hassall John,
York John
Publication year - 1971
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1971.tb92554.x
Subject(s) - medicine , rheumatoid arthritis , rheumatism , chlorambucil , disease , fulminant , methylprednisolone , steroid , arthritis , surgery , chemotherapy , cyclophosphamide , hormone
A trial of chlorambucil has been undertaken at the Royal Prince Alfred Hospital over the last two years in the treatment of severe rheumatoid arthritis. Two groups of patients have been followed: (i) patients with severe, unremitting rheumatoid arthritis who had been on steroid therapy for long periods; (ii) eight patients with fulminant rheumatoid arthritis who had not previously been on steroids. The ability to withdraw corticosteroid drugs without producing a relapse of the disease process, and an estimation of the functional grades of activity as set down by the American Rheumatism Association, were the chief parameters of assessment. Although the numbers are small and the study is uncontrolled, considering the degree of severity of the disease in the patients under study and the difficulties ordinarily encountered in attempting to withdraw steroids from patients who have been taking them for long periods, the results are encouraging. In group (i), 87% achieved a 50% or more reduction in steroid dosage; 65% had steroids withdrawn altogether; 50% improved by at least one grade of functional activity. In group (II), these patients began steroid therapy concurrently with chlorambucil therapy. All had the steroids withdrawn. Fifty per cent of these eight patients improved by two grades of functional activity, 25% by three grades and 25% by one grade. Three patients in this group returned to their former occupations. Herpes zoster was the major side effect encountered, occurring in four cases. It did not warrant withdrawal of therapy In any Instance.