Assessment of Cyclosporine Oral Solution in Patients with Severe Rheumatoid Arthritis

Abstract

AbstractBackground: patients with severe rheumatoid arthritis treated with cyclosporine A, frequently showed variability in important improvement.Objectivs: This study aimed to assess the effectiveness of oral cyclosporine solution in management of severe rheumatoid arthritis.Methods: In this prospective study, the efficacy and safety of 5 mg per kilogram body weight per day, oral solution of microemulsion pharmaceutical formulation of cyclosporine (Neoral) was assessed in thirty three patients with severe refractory rheumatoid arthritis in Consultant clinic at Al-Yarmook teaching hospital during 2004. None of patient population showed any previous important improvement to methotrexate, sulfasalazine and/or hydroxychloroquine as monotherapy or in different combinations.Results: 21 out of 33 (63.6%) patients with severe rheumatoid arthritis showed marked improvement i.e. fulfill at least 50% improvement in American College of Rheumatology (ACR) criteria. The remaining number of twelve patients (36.4%) were discontinued the treatment because of adverse reactions and/or ineffective therapy. Patients who continued the therapy and showed improvement were; females rather than males, older, with longer duration of disease, the more period of morning stiffness, the higher leucocytes count, the lower hemoglobin level, and the higher frequency of positive latex test and higher serum C-reactive protein level.Conclusion: Microemulsion oral pharmaceutical formulation of, stable 5 mg per kilogram body weight per day cyclosporine A, is effective and safe remedy for severe rheumatoid arthritis.