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Nitrogen mustard in severe rheumatoid arthritis

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Summary

The value of intravenous bolus therapy was investigated in patients with severe active rheumatoid arthritis. Nitrogen mustard was given in 3 intravenous bolus injections (0.1mg/kg body weight) over 3–5 weeks. In a controlled study of 11 patients the actively treated ones (7 cases) showed greater improvement in all the clinical and laboratory variables measured than did the controls (4 cases). A prospective evaluation of this treatment in 22 patients over 6–18 months showed it had a persistent effect and was associated with clinically significant improvements in the assessments of disease activity. We consider bolus therapy with intravenous nitrogen mustard to be of value, but its use should be restricted to patients with severe rheumatoid arthritis during hospital admission, and it should be combined with other therapy.

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References

  1. Gerber, N.L., Steinberg, A.D. Clinical use of immunosuppressive drugs. Drugs 1976, 11, 14–35.

    Article  PubMed  CAS  Google Scholar 

  2. Liebling, M.R., Lieb, E., Mclaughlin, K., Blocka, K., Furst, D.E., Nyman, K., Paulus, H.E. Pulse methylprednisolone in rheumatoid arthritis: a double-blind cross-over trial. Ann. Intern. Med. 1981, 94, 21–26.

    PubMed  CAS  Google Scholar 

  3. Hess, E.V., Kammen, P.L. Pulse therapy in rheumatoid arthritis Ann. Intern. Med. 1981, 94, 128–129.

    PubMed  CAS  Google Scholar 

  4. Kotzin, B.L., Stober, S., Engelman, E.G., Calin, A., Hoppe, R.T., Kansas, G.S., Terrell, C.P., Kaplan, H.S. Treatment of intractable rheumatoid arthritis with total lymphoid irradiation. N. Engl. J. Med. 1981, 305, 969–975.

    Article  PubMed  CAS  Google Scholar 

  5. Trentham, D.E., Belli, J.A., Anderson, R.J., Buckley, J.A., Goetzl, E.J., David, J.R., Ausken, K.F. Clinical and immunological effects of fractional total lymphoid irradiation in refractory rheumatoid arthritis. N. Engl. J. Med. 1981, 305, 976–981.

    Article  PubMed  CAS  Google Scholar 

  6. Scott, D.G.I., Bacon, P.A., Allen, C., Elson, C.J., Wallington, T. IgG rheumtoid factor, complement and immune complexes in rheumatoid synovitis and vasculitis; comparative and serial studies during cytotoxic therapy. Clin. Exp. Immunol. 1981, 43, 54–63.

    PubMed  CAS  Google Scholar 

  7. Jimenez Diaz, C. Treatment of dysreaction diseases with nitrogen mustards. Ann. Rheum. Dis. 1951, 10, 144–152.

    Article  PubMed  CAS  Google Scholar 

  8. Jimenez Diaz, C., Merchante, A., Perianes, J., Lopez Garcia, E., Puig Leal, J. Treatment of disease of dysreaction with nitrogen mustard. I. Rheumatoid arthritis. Rev. Clin. Esp. 1950, 38, 261–272.

    PubMed  CAS  Google Scholar 

  9. Popert, A.J. Chloroquine: a review. Rheumatol Rehabil. 1976, 15, 235–238.

    Article  PubMed  CAS  Google Scholar 

  10. Steinbroker, O., Traeger, C.H., Batterman, R.C. Therapeutic criteria in rheumatoid arthritis. J.A.M.A. 1949, 140, 659–662.

    Google Scholar 

  11. Hodges, P.W., Bean, R.E., Routh, W.B., Daum, K. Effects of nitrogen mustard therapy in patients with rheumatoid arthritis. Arch. Phys. Med. 1954, 35, 371–376.

    PubMed  Google Scholar 

  12. Robecchi, A., Cartesegna, F., Danco, V. Observations on 69 cases of rheumatoid arthritis treated with Di-(2-chloroethyl)-methylamines hydrochloride. Rev.Rhum. Mal Osteoartic. 1954, 21, 823–826.

    PubMed  CAS  Google Scholar 

  13. Losada, M., Etcheverry, L.R., Daiber, A., Guzman, C. Experience with nitrogen mustard in the treatment of rheumatoid arthritis. Rev. Med. Chil. 1952, 80, 164–168.

    PubMed  CAS  Google Scholar 

  14. Retboll, G., Egemose, T., Hosti, J.E. Treatment of polyarthritis chronica with nitrogen mustard (Erassi). Acta. Med. Scand. 1955, 151, 289–294.

    PubMed  CAS  Google Scholar 

  15. Segal, A.M., Couri, J.M., Clough, J.D., Krakauer, R.S. Treatment of the acute flare of rheumatoid arthritis; intravenous nitrogen mustard versus intravenous methylprednisolone pulse. Revue Rheum. Mal. Osteoartic. (XVth International Congress of Rheumatology) 1981, Abstract 130.

  16. Layle, J.K. Lymphoid irradiation for rheumatoid arthritis. N. Eng. J. Med. 1982, 306, 487.

    Article  Google Scholar 

  17. Jones, J.G., Lewis, P., Hazleman, B.L. The treatment of persistent synovitis with nitrogen mustard. Rheumatol. Rehab. 1980, 19, 154–160.

    Article  CAS  Google Scholar 

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Kitt, R., Scott, D.L., Coulton, B.L. et al. Nitrogen mustard in severe rheumatoid arthritis. Clin Rheumatol 2, 27–35 (1983). https://doi.org/10.1007/BF02032065

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