Nitrogen mustard as induction therapy for rheumatoid arthritis: clinical and immunologic effects.
We treated 5 patients diagnosed with rheumatoid arthritis (RA) with nitrogen mustard (HN2) and monitored clinical and immunologic variables. HN2, 0.3 mg/kg ideal body weight was given over 7 days. Disease activity and immune function were monitored during and after treatment. Duration of morning stiffness (p = 0.0044), joint count (p = 0.0140), and assessment of pain (p = 0.0264) and function (p = 0.0057) improved by Day 6. T lymphocytes (p = 0.0060), especially T memory cells (CD4CD29; p = 0.0017) fell dramatically. HN2 is effective for rapidly gaining control of active RA. This effect is T cell specific.
Danao
T
T
Department of Rheumatic and Immunologic Disease, Cleveland Clinic Foundation, Ohio 44195.
Ropos
T
T
Wilke
W
W
Segal
A
A
Calabrese
L
L
Valenzuela
R
R
Gragg
L
L
Clough
J
J
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009588:Nitrogen Mustard Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000503:physiopathology; D012720:Severity of Illness Index; D013601:T-Lymphocytes / Q000473:pathology; D013997:Time Factors
D009588:Nitrogen Mustard Compounds