Reversible nephrotoxicity of cyclosporine in rheumatoid arthritis.
Irreversible nephrotoxicity has limited the use of cyclosporine in rheumatoid arthritis (RA). In a randomized clinical trial we compared 26 weeks of cyclosporine (5 mg/kg) and D-penicillamine (250 mg) treatment in 92 patients with RA with a serum creatinine less than 100 mumol/l. We adjusted the starting dose according to clinical response and side effects. During cyclosporine treatment the serum creatinine increased by median 15% (p less than 0.0001 vs baseline), quickly reversible after stopping (median followup: 1.6 years). Six patients stopped cyclosporine prematurely because of nephrotoxicity. In the D-penicillamine group the values remained at baseline.
Boers
M
M
Department of Rheumatology, University Hospital Leiden, The Netherlands.
Dijkmans
B A
BA
van Rijthoven
A W
AW
Goei Thè
H S
HS
Cats
A
A
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D003404:Creatinine / Q000097:blood; D003524:Cyclosporins / Q000009:adverse effects* / Q000494:pharmacology; D004311:Double-Blind Method; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003524:Cyclosporins; D003404:Creatinine; D010396:Penicillamine