title: Limited utility of rapamycin in severe, refractory Wegener's granulomatosis.
abstract: OBJECTIVE
  We report our experience using rapamycin in patients with Wegener's granulomatosis (WG) who failed to achieve remission with conventional treatment.
  
  
  METHODS
  Eight patients received rapamycin for severe, refractory WG. Clinical outcomes were reviewed retrospectively.
  
  
  RESULTS
  Four patients treated with rapamycin sustained remissions of at least 6 months' duration while receiving prednisone<or=10 mg/day; 2 relapsed during followup. Five patients discontinued rapamycin due to continued disease activity, cancer, or adverse events.
  
  
  CONCLUSIONS
  Toxicities due to rapamycin were numerous; consistent proof of efficacy in this pilot experience with WG was not seen.
authors.affiliation: Cleveland Clinic, Center for Vasculitis Care and Research, Department of Rheumatic and Immunologic Diseases, Cleveland, OH, USA. Curry.Koening@hsc.utah.edu
authors.forename: Curry L
authors.initials: CL
authors.lastname: Koening
authors.forename: José
authors.initials: J
authors.lastname: Hernández-Rodríguez
authors.forename: Eamonn S
authors.initials: ES
authors.lastname: Molloy
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: Clark
authors.forename: Gary S
authors.initials: GS
authors.lastname: Hoffman
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020123:Sirolimus / Q000008:administration & dosage* / Q000009:adverse effects; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus