מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Cyclosporine is significantly more effective than sulfasalazine or symptomatic therapy in relieving pain and improving clinical variables in patients with psoriatic arthritis, according to the results of a multicenter study.
Dr. Carlo Salvarani, of Arcispedale S. Maria Nuova, in Reggio Emilia, Italy, and colleagues compared the three treatment approaches in 99 patients with active psoriatic arthritis. Patients were randomly assigned to receive cyclosporine, 3 mg/kg per day; sulfasalazine, 2000 mg per day plus symptomatic therapy; or symptomatic therapy alone. Symptomatic therapy included nonsteroidal anti-inflammatory drugs, analgesics, and/or prednisone. The subjects were treated for 24 weeks in this open study.
"Our results show that cyclosporine is more effective in treating psoriatic arthritis than sulfasalazine or symptomatic therapy alone," Dr. Salvarani's group reports in the October issue of The Journal of Rheumatology. Specifically, patients in the cyclosporine group showed significant improvement in pain scores compared with the sulfasalazine and the symptomatic group (p < 0.05).
Moreover, cyclosporine resulted in significantly greater improvements than sulfasalazine alone in swollen joint count (p = 0.05), tender joint count (p = 0.01) and joint pain/tenderness score (p = 0.002). Patient and physician global assessment scores, total Arthritis Impact Measurement Scale score, and spondylitis functional index were also significantly better in the cyclosporine group.
While the benefits of cyclosporine were observed as early as 8 weeks after the initiation of treatment, the effects of sulfasalazine on spondylitis functional index were observed only at 24 weeks, the investigators report.
Cyclosporine was well tolerated by patients. The most common adverse event in this group was a mild kidney dysfunction, which was reversible with cyclosporine dose reduction.
"The results of this open trial confirm that cyclosporine is well tolerated by patients with psoriatic arthritis, and suggest that it is more efficacious than symptomatic therapy or sulfasalazine," Dr. Salvarani and colleagues conclude.
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