RESUMEN
OBJECTIVE: To define clinical and laboratory outcomes of longterm recombinant interferon-gamma (rIFN-gamma) treatment of patients with rheumatoid arthritis (RA). METHODS: Patients with RA (70) completing a 12-week multicenter double blind trial comparing rIFN-gamma with placebo were enrolled in a longterm prospective protocol evaluating rIFN-gamma in RA. RESULTS: The majority of patients sustained clinical improvement for one year. Eight (11%) patients with RA continued to receive rIFN-gamma after 5 years. One patient fulfilled remission criteria. rIFN-gamma was well tolerated with remarkably few suspected adverse drug reactions. Forty-seven (67%) patients discontinued rIFN-gamma because of lack of efficacy, 7 (10%) because of concurrent illnesses, 5 (7%) were not compliant to study protocol, 3 (4%) developed suspected adverse drug reactions for a total of 62 (89%) withdrawals over the 5 years of followup. Patients continuing rIFN-gamma treatment for 5 years had lower initial total leukocyte and neutrophil counts and higher hemoglobin and hematocrit levels than patients who discontinued rIFN-gamma during the 5-year followup. CONCLUSIONS: Longterm treatment of RA with rIFN-gamma was generally well tolerated. Although many patients maintained sustained clinical improvement for at least one year, the main reason for discontinuing the drug over 5 years was the lack of continued benefit.
Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/epidemiología , Interferón gamma/uso terapéutico , Artritis Reumatoide/diagnóstico por imagen , Artrografía , Método Doble Ciego , Estudios de Seguimiento , Estado de Salud , Humanos , Interferón gamma/efectos adversos , Articulaciones/patología , Estudios Prospectivos , Proteínas Recombinantes , Factores de TiempoAsunto(s)
Corticoesteroides/administración & dosificación , Sulfasalazina/administración & dosificación , Urticaria/tratamiento farmacológico , Corticoesteroides/efectos adversos , Adulto , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inducción de Remisión , Trastornos Relacionados con SustanciasRESUMEN
Seventy patients with rheumatoid arthritis (RA) completing a 12-week multicenter double blind trial comparing recombinant human interferon-gamma (r-IFN-gamma) with placebo were enrolled in a longterm prospective protocol evaluating r-IFN-gamma in RA. Forty (57%) patients after 1 year and 26 (37%) patients after 2 years continued the drug with sustained clinical benefit. Over 2 years, r-IFN-gamma was discontinued in 44 patients (lack of efficacy--25, withdrawn consent--7, noncompliant--4, suspected adverse drug reactions--2, concurrent illness--6). Two years of treatment with r-IFN-gamma were well tolerated with sustained clinical benefit in some patients with few significant adverse drug reactions.
Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Interferón gamma/uso terapéutico , Artritis Reumatoide/sangre , Artritis Reumatoide/fisiopatología , Recuento de Células Sanguíneas , Estudios de Seguimiento , Humanos , Interferón gamma/efectos adversos , Articulaciones/fisiopatología , Dolor , Estudios Prospectivos , Proteínas RecombinantesRESUMEN
One hundred five patients were enrolled in a 12-week, randomized, prospective, double-blind, placebo-controlled trial of recombinant human gamma-interferon (rHu gamma-IFN) for the treatment of rheumatoid arthritis. Fifty-four patients received rHu gamma-IFN and 51 received placebo. Forty-two patients in each group completed the 12-week trial. Some clinical improvement occurred in both groups of patients. Although the improvement with rHu gamma-IFN was greater than that with placebo, the differences were generally not statistically significant.
Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Interferón gamma/uso terapéutico , Placebos/uso terapéutico , Adulto , Anciano , Antígenos de Superficie/metabolismo , Artritis Reumatoide/inmunología , Artritis Reumatoide/metabolismo , Ensayos Clínicos como Asunto , Método Doble Ciego , Tolerancia a Medicamentos , Femenino , Humanos , Interferón gamma/efectos adversos , Leucocitos/inmunología , Leucocitos/metabolismo , Masculino , Proteínas de la Membrana/metabolismo , Persona de Mediana Edad , Proteínas Recombinantes , Factores de TiempoRESUMEN
Two patients with profound decrease of alpha1-antitrypsin (PiZZ) presented with severe pannicultis (Weber-Christian disease); one had systemic panniculitis including pancreatitis. Another possible case is quoted from the literature. Although milder forms of panniculitis can have normal Pi phenotypes and alpha1-antitrypsin levels, the marked reduction of antiproteolytic activity found in PiZZ homozygotes may predispose to or aggravate the lesions of Weber-Christian disease.
Asunto(s)
Paniculitis Nodular no Supurativa/complicaciones , Deficiencia de alfa 1-Antitripsina , Adulto , Trastornos de las Proteínas Sanguíneas/complicaciones , Humanos , Masculino , Pancreatitis/complicaciones , FenotipoRESUMEN
Three patients developed an acute hemarthrosis related to sodium warfarin. Synovial aspiration was well tolerated and necessary to substantiate the diagnosis. Prior joint disease was present in two but in only one was there a definite precipitating event, namely minor trauma. The prothrombin time was within the therapeutic range in two of the three. The acute synovitis subsided after the warfarin was discontinued. Joint function seems to have fully returned but long-term evaluation is needed.