title: Cyclosporine nephrotoxicity in rheumatoid arthritis: no effect of short term misoprostol treatment.
abstract: We assessed the effect of the prostaglandin E1 analog misoprostol on cyclosporine nephrotoxicity in patients with rheumatoid arthritis (RA). Thirteen patients with RA were given cyclosporine with misoprostol tablets, 800 micrograms/day for one week in a randomized, double blind, placebo controlled crossover trial. All had cyclosporine nephrotoxicity, documented by an increase in serum creatinine of at least 15% over the values before the start of cyclosporine treatment. Mean glomerular filtration rate (GFR) (single shot 51Cr-EDTA plasma clearance) at baseline was 77.3 ml/min (SD, 22.0). After misoprostol, it was 80.0 ml/min (SD, 18.9); after placebo, 79.1 ml/min (SD, 20.0). None of these changes were statistically significant. Serum creatinine levels and whole blood cyclosporine levels were also unchanged. Power to detect at least a 5 ml/min rise in GFR was 0.92. Short term misoprostol treatment does not improve the GFR of patients with RA on cyclosporine.
authors.affiliation: Department of Internal Medicine/Rheumatology, University Hospital, Maastricht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Boers
authors.forename: W G
authors.initials: WG
authors.lastname: Bensen
authors.forename: D
authors.initials: D
authors.lastname: Ludwin
authors.forename: C H
authors.initials: CH
authors.lastname: Goldsmith
authors.forename: P
authors.initials: P
authors.lastname: Tugwell
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D016572:Cyclosporine / Q000506:poisoning* / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D016595:Misoprostol; D016572:Cyclosporine