Skip to main content
SpringerLink
Log in

Cyclosporine and rheumatoid arthritis

  • Published:
Springer Seminars in Immunopathology Aims and scope Submit manuscript

Conclusions

All the studies so far performed indicate that CS treatment in RA is effective. But it is also clear that CS-induced nephrotoxicity is so far the main problem. However, nephrotoxicity can be minimized by lowering the CS dosage and by ensuring that RA patients subjected to CS therapy have a normal kidney function and no history of hypertension. Hypertrichosis due to CS therapy is also a considerable problem, since the majority of patients with autoimmune diseases are women. Malignant lymphomas are a minor problem as so far there have only been two reported cases among 2500 CS-treated patients with autoimmune diseases.

We believe that CS alone or in combination with other drugs will find its place in the treatment of RA and other autoimmune diseases in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adu D, Michael J, Turney J, McMaster P (1983) Hyperkalaemia in cyclosporine-treated renal allograft recipients. Lancet II: 370

    Google Scholar 

  2. Berg KJ, Førre Ø, Bjerkhoel F, Amundsen E, Djøseland O, Rugstad HE, Westre B (1986) Renal side effects of cyclosporine A treatment in patients with rheumatoid arthritis. Kidney Int 29: 1180

    PubMed  Google Scholar 

  3. Bird HA, Yu H, Cooper EH (1984) Renal proximal dysfunction in rheumatic diseases. Br Med J 288: 1044

    Google Scholar 

  4. Borel JF, Ryffel B (1985) The mechanism of action of cyclosporine: a continuing puzzle. In: Schindler R (ed) Cyclosporine in autoimmune diseases. Springer, Berlin Heidelberg New York Tokyo, pp 24–32

    Google Scholar 

  5. Borel JF, Wiesinger D, Bubler HV (1978) Effects of the anti-lymphocytic agent cyclosporine A in chronic inflammation. Eur J Rheumatol Inflamm 1: 237

    Google Scholar 

  6. Brun C, Steen-Olsen T, Raaschou F, Sørensen AWS (1965) Renal biopsy in rheumatoid arthritis. Nephron 2: 65

    PubMed  Google Scholar 

  7. Burke M (1987) Effect of cyclosporine on glomerular prostaglandin production. The second international congress on cyclosporine, Washington, Abstracts, p 35

  8. Cantarovich F (1987) Cyclosporine dose adjustment in patients with “normal” serum creatinine and trough levels: a challenge for successful long-term treatment. The second international congress on cyclosporine, Washington, Abstracts, p 26

  9. Cavanack T, Sucker H (1986) Formulation of dosage forms. In: Borel JF (ed) Cyclosporine. Karger, Basel, pp 65–72

    Google Scholar 

  10. Dougados M, Amor B (1987) Cyclosporine A in rheumatoid arthritis: preliminary clinical results of an open trial. Arthritis Rheum 30: 83

    PubMed  Google Scholar 

  11. Dougados M, Awada H, Amor M (1987) Cyclosporine in rheumatoid arthritis: a double blind placebo-controlled trial in 52 patients. Clin Exp Rheumatol [Suppl 2] 5: 124

    Google Scholar 

  12. Duff GW, di Giovine F, Manson J, Nuki G (1987) Tumour necrosis factor in rheumatic diseases. Clin Exp Rheumatol [Suppl 2] 5: 59

    PubMed  Google Scholar 

  13. Dumont F (1987) Intracellular conversion of non-cyclophilin bindingO-acetyl andO-formyl-cyclosporine to bioactive forms. The second international congress on cyclosporine, Washington, Abstracts, p 67

  14. Egel J, Greenberg A, Thopson M (1983) Renal failure (RF) in heart transplant patients receiving cyclosporine. Transplant Proc 15: 2706

    Google Scholar 

  15. Førre Ø, Waalen K, Thoen J, Hovig T (1985) Macrophages and dendritic cells in rheumatic diseases. In: Gupta S, Talal N (eds) Immunology of rheumatic diseases. Plenum Press, New York, pp 543–562

    Google Scholar 

  16. Førre Ø, Bjerkhoel F, Salvesen CF, Berg KJ, Rugstad HE, Saelid G, Mellbye OJ, Kåss E (1987) An open, controlled, randomized comparison of cyclosporine and azathioprine in the treatment of rheumatoid arthritis: a preliminary report. Arthritis Rheum 30: 88

    Google Scholar 

  17. Granelli-Piperno A (1987) Cyclosporine inhibits cell-mediated immunity at the level of T lymphocyte rather than the accessory cell. The second international congress on cyclosporine, Washington, Abstracts, p 111

  18. Hamilton TA, Adams DO (1987) Molecular mechanisms of signal transduction in macrophages. Immunol Today 8: 151

    Google Scholar 

  19. Henry M (1987) Cyclosporine blood levels are not helpful. The second international congress on cyclosporine, Washington, Abstracts, p 29

  20. Hermann B, Muller W (1979) Die Therapie der chronischen polyarthritis mit cyclosporine A, einem neuen immunosuppressive. Aktuel Rheumatol 4: 173

    Google Scholar 

  21. Janossy G, Duke O, Poulter LW, Panayi G, Bofill M, Goldstein G (1981) Rheumatoid arthritis: a disease of T lymphocyte/macrophage immunoregulation. Lancet II: 839

    Google Scholar 

  22. Kahan BD, Wideman C, Reid M, Gibbons S, Jarowenko M, Flechner S, Van Buren CT (1984) The value of serial serum trough cyclosporine levels in human renal transplantation. Transplant Proc 16: 1195

    PubMed  Google Scholar 

  23. Kebwn PA, Stiller CR, Stawecki M, McMichael J, Howson W (1985) Pharmacokinetics and interactions of cyclosporine. In: Schindler R (ed) Cyclosporine in autoimmune diseases. Springer, Berlin Heidelberg New York Tokyo, pp 39–42

    Google Scholar 

  24. Lemaire M, Maurer G, Wood AJ (1986) Pharmacokinetics and metabolism. In: Borel JF (ed) Cyclosporine. Karger, Basel, pp 93–107

    Google Scholar 

  25. Levy SB, Lilley JJ, Frigon RP, Stone RA (1977) Urine kallikrein and plasmarenin activity as determinants of renal blood flow. J Clin Invest 60: 129

    PubMed  Google Scholar 

  26. Loertscher R, Scholer A, Brunner F, Harder F, Thiel G (1982) Klinische Relevanz derN-acetyl-Glucosaminidase-Bestimmung im Urin bei Nierentransplantatempfängern mit und ohne Cyclosporine A. Klin Med Wochenschr 112: 1658

    Google Scholar 

  27. Miescher PA, Favre H, Chatelanat S, Mihatsch MJ (1987) Combined steroid/cyclosporine treatment of chronic autoimmune diseases. Min WochenSchr 65: 727

    Google Scholar 

  28. Mihatsch MJ, Bohman SO, von Graffenried B, Harrison WB (1986) First interim report of renal biopsy registry of patients with autoimmune diseases treated with cyclosporine. Sandoz, Basel

    Google Scholar 

  29. Mihatsch MJ, Thiel G, Ryffel B (1986) Morphology of cyclosporine nephropathy. In: Borel JF (ed) Cyclosporine. Karger, Basel, pp 447–465

    Google Scholar 

  30. Munthe E, Natvig JB (1972) Immunoglobulin classes, subclasses and complexes of IgG rheumatoid factor in rheumatoid plasma cells. Clin Exp Immunol 12: 55

    PubMed  Google Scholar 

  31. Myers BD, Ross J, Newton L, Luetscher J, Perlroth M (1984) Cyclosporine-associated chronic nephropathy. N Engl J Med 311: 699

    PubMed  Google Scholar 

  32. NIH Conference (1984) Rheumatoid arthritis: evolving concept of pathogenesis and treatment. Ann Intern Med 101: 810

    Google Scholar 

  33. Nussenblatt RB, Palestine AG, Rouk AH, Seher I, Wacker WB, Cyery I (1983) Treatment of intra-ocular inflammatory disease with cyclosporine A. Lancet II: 235

    Google Scholar 

  34. Palestine AG, Nussenblatt RB, Chan CC (1984) Side effects of systemic cyclosporine in patients not undergoing transplantation. Am J Med 77: 652

    PubMed  Google Scholar 

  35. Palestine AG, Austin HA, Barlow JE, Antonovych TT, Sabnis SG, Preuss HG, Nussenblatt RB (1986) Renal histopathologic alterations in patients treated with cyclosporine for uveitis. N Engl J Med 314: 1293

    PubMed  Google Scholar 

  36. Pasternak A, Igelius O, Makisara P (1967) Renal biopsy in rheumatoid arthritis. Acta Med Scand 182: 591

    PubMed  Google Scholar 

  37. Penn I (1982) Malignancies following the use of cyclosporine A in man. Cancer Surv 1: 621

    Google Scholar 

  38. Quesniaux V, Tees R, Schreier MH, Wenger RM, Donatsch P, Van Regenmortel MHV (1986) Monoclonal antibodies to cyclosporine. In: Borel JF (ed) Cyclosporine. Karger, Basel, pp 108–122

    Google Scholar 

  39. Ropes MW, Bennet GA, Cobb S, Jacox R, Jessar RA (1958) 1958 revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis 9: 175

    PubMed  Google Scholar 

  40. Ruddle NH (1987) Tumor necrosis factor and related cytotoxins. Immunol Today 8: 129

    Google Scholar 

  41. Russ GR, Horgan BA, Mathew TH, Mills L, Kirkland JA (1982) Beta-2-microglobulin excretion and urinary cytology in analgesic nephropathy. Clin Nephrol 18: 148

    PubMed  Google Scholar 

  42. Salmeron B, Lipsky PE (1983) Immunsuppressive potential of anti-malarials. Am J Med [Suppl] 75: 19

    Google Scholar 

  43. Schran HF, Robinson WT, Abisch E, Niederberger W (1986) Bioanalytical considerations. In: Borel JF (ed) Cyclosporine. Karger, Basel, pp 73–92

    Google Scholar 

  44. Stiller CR, Durpe J, Gent M, Jenner MR, Keown PA, Laupacis A, Martell R, Rodger NW, von Graffenried B, Wolfe BMJ (1984) Effects of cyclosporine: immuno-suppression in insulindependent diabetes mellitus of recent onset. Science 223: 1362

    PubMed  Google Scholar 

  45. Van Rijthoven AWAM, Dijkmans BAC, Goei The HS, Hermans J, Montnor-Beckers ZLMB, Jacobs PCJ, Cats A (1986) Cyclosporine treatment for rheumatoid arthritis: a placebo-controlled, double blind, multicentre study. Ann Rheum Dis 45: 726

    PubMed  Google Scholar 

  46. Von Graffenried B, Harrison WB (1985) Cyclosporine in autoimmune diseases-Side effects (with emphasis on renal dysfunction) and recommendations for use. In: Schindler R (ed) Cyclosporine in autoimmune diseases. Springer, Berlin Heidelberg New York Tokyo, pp 59–73

    Google Scholar 

  47. Von Wartburg A, Traber R (1986) Chemistry of the natural cyclosporine metabolites. In: Borel JF (ed) Cyclosporine. Karger, Basel, pp 28–45

    Google Scholar 

  48. Waalen K, Duff GW, Førre Ø, Dickens E, Kvarnes L, Nuki G (1986) Interleukin 1 Activity produced by human rheumatoid and normal dendritic cells. Scand J Immunol 23: 365

    PubMed  Google Scholar 

  49. Waalen K, Førre Ø, Linker-Israeli M, Thoen J (1987) Evidence of an activated T-cell system with augmented turnover of interleukin 2 in rheumatoid arthritis. Stimulation of human T lymphocytes by dendritic cells as a model for rheumatoid T cell activation. Scand J Immunol 25: 367

    PubMed  Google Scholar 

  50. Weinblatt ME, Coblyn JS, Fraser PA, Anderson, RJ, Spragg J, Trentham DE, Austen F (1987) Cyclosporine A treatment of refractory rheumatoid arthritis. Arthritis Rheum 30: 11

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oslo Sanitetsforenings Rheumatism Hospital, Akersbakken 27, N-0172, Oslo 1, Norway

    Ø. Førre & E. Kåss

  2. Institute of Immunology and Rheumatology, Fredrikke Qvamsgate 1, N-0172, Oslo 1, Norway

    K. Waalen

  3. Department for Clinical Pharmacology, Rikshospitalet, The National Hospital, N-0172, Oslo 1, Norway

    H. E. Rugstad

  4. Medical Department B, Renal Section, Rikshospitalet, The National Hospital, N-0172, Oslo 1, Norway

    K. J. Berg

  5. Sandozinformasjon, Økernveien 121, N-0510, Oslo 5, Norway

    D. Solbus

Authors
  1. Ø. Førre
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Waalen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. E. Rugstad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. J. Berg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Solbus
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Kåss
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Førre, Ø., Waalen, K., Rugstad, H.E. et al. Cyclosporine and rheumatoid arthritis. Springer Semin Immunopathol 10, 263–277 (1988). https://doi.org/10.1007/BF01857229

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01857229

Keywords

Search

Navigation