What is pulse cyclophosphamide?
Intravenous pulse cyclophosphamide has been used in the treatment of several diseases, including neuropsychiatric lupus erythematosus,28 lupus nephritis,29 Wegener granulomatosis,30 Behçet disease,31 and pyoderma gangrenosum associated with rheumatoid arthritis.
How do you administer cyclophosphamide pulse therapy?
Intermittent pulse therapy protocol Intermittent pulse cyclophosphamide therapy was given intravenously at a dose of 10 mg/kg three weekly for four doses, then orally at the same dose split over two days at four weekly interval for nine months, and finally at six weekly intervals for 12 months (appendix 1).
Is there still a role for cyclophosphamide in the treatment of systemic sclerosis?
Treatment with cyclophosphamide has shown survival benefit in patients with SSc-ILD in a retrospective study; however, a survival benefit of 1-year treatment with oral cyclophosphamide was not found in the SLS I and SLS II.
What is a marker for scleroderma?
Typically, the rheumatologist will order an ANA (antinuclear antibody, an antibody commonly found in many of the autoimmune diseases), as well as an Scl-70 antibody (positive in some patients with diffuse scleroderma), anticentromere antibody (generally felt to be a marker for limited scleroderma), and an antibody …
What is the mechanism of action of cyclophosphamide?
MECHANISM OF ACTION: Cyclophosphamide is an alkylating agent of the nitrogen mustard type. 2 An activated form of cyclophosphamide, phosphoramide mustard, alkylates, or binds, to DNA. Its cytotoxic effect is mainly due to cross-linking of strands of DNA and RNA, and to inhibition of protein synthesis.
What is pulse methylprednisolone therapy?
Pulse IV methylprednisolone therapy is the intermittent administration of supraphysiological quantities of the drug to enhance its therapeutic effects while reducing its toxic effects. 1. A typical pulse regimen ranges from 500 to 1000 mg IV daily for 2–4 consecutive days.
What ANA pattern is scleroderma?
Approximately 95% of people with systemic scleroderma have a positive antinuclear antibody (ANA) test, but so do people with other autoimmune diseases (97% of people with lupus, as an example). People with localized scleroderma usually have negative ANA.
What is the pinch test for scleroderma?
“In using a skin scoring system, the physician pinches various parts of the patient’s body to test for thickness. The less skin that can be pinched equals a higher score in diagnosing scleroderma,” says Feghali-Bostwick.
What are the indications of cyclophosphamide?
Cyclophosphamide is indicated for the treatment of:
- malignant lymphomas (Stages III and IV of the Ann Arbor staging system), Hodgkin’s disease, lymphocytic lymphoma (nodular or diffuse), mixed-cell type lymphoma, histiocytic lymphoma, Burkitt’s lymphoma.
- multiple myeloma.
What does cyclophosphamide treat?
Cyclophosphamide is used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in children). Cyclophosphamide is also used for retinoblastoma (a type of eye cancer mainly in children), multiple myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin).
How is cyclophosphamide used to treat SSC-ILD?
According to EULAR recommendations, cyclophosphamide (CYC) is the first choice of therapy for treating SSc-ILD [9]. Cyclophosphamide acts as a cytotoxic immunosuppressive agent through modulation of lymphocyte function that leads to depression of the inflammatory response and less fibrosis [10, 11].
Does cyclophosphamide improve pulmonary function in scleroderma and alveolitis?
Cyclophosphamide is associated with pulmonary function and survival benefit in patients with scleroderma and alveolitis. Ann Intern Med. 2000;132:947–954. doi: 10.7326/0003-4819-132-12-200006200-00004.
How does cyclophosphamide affect lymphocytes?
Cyclophosphamide acts as a cytotoxic immunosuppressive agent through modulation of lymphocyte function that leads to depression of the inflammatory response and less fibrosis [10, 11]. Several uncontrolled studies showed a positive effect on pulmonary function in patients receiving cyclophosphamide [12–19].
Is monthly CYC pulse therapy effective for systemic lupus erythematosus (SSC)?
Since 2003, intravenous, monthly CYC pulse therapy is the first of choice therapy for SSc-ILD and/or rapid progressive diffuse SSc at our Department of Rheumatology of the Radboudumc. All patients since then diagnosed with SSc-ILD who started treatment with monthly iv CYC pulses (dose 750 mg/m2) were analyzed in this study.