EFFECTIVENESS AND SAFETY PROFILE OF CYCLOSPORIN A IN RHEUMATOID ARTHRITIS

Objectives: To describe the effectiveness and safety profile of Cyclosporine A in the treatment of Rheumatoid Arthritis. Methodology: The study was conducted in the department of Medicine, Khyber Teaching Hospital from Sep 98 to Aug 99. There was three months recruitment period i.e. July to September prior to the actual treatment phase. Those patients that fulfilled the criteria of the American College of Rheumatology for Rheumatoid Arthritis were included in the study. A total of 25 patients with Rheumatoid Arthritis (RA) completed the study. Patients started on Cyclosporine A were followed for a period of one year. Results: Outcome was assessed in respect of functional grade and joint score during the study and at the end of one year and was graded as very good, good and poor. Sixty percent patients showed very good to good response to Cyclosporine treatment, as they were in functional class 1 and showed more than 80% reduction in joint score. The other 40% had poor response as they were in functional class 2 or more and had less than 80% reduction in joint score. Mild hypertension was seen in 2 (8%) patients. Two (8%) patients developed hypertrichosis. One patient with severe gingival hyperplasia eventually dropped out of the study. None of the patients showed elevation of serum creatinine level above 30% of the baseline values at any time during treatment. Conclusion: The study shows that Cyclosporine A is an effective agent in active and potentially disabling RA. It has a good safety profile when used in recommended doses.