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February 7, 2003Arthritis Care & Research

Treatment of polyarteritis nodosa and microscopic polyangiitis with poor prognosis factors: A prospective trial comparing glucocorticoids and six or twelve cyclophosphamide pulses in sixty‐five patients

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Why the study?

Does 12 cyclophosphamide pulses compared to 6 pulses reduce relapses and/or deaths in patients with severe polyarteritis nodosa and microscopic polyangiitis?

Population

65 previously untreated patients with severe disease without virus infection.

Comparison

12 cyclophosphamide pulses combined with… vs 6 cyclophosphamide pulses combined with…

Design

RCT, randomized

Follow-up

mean 32 +/- 21 months

Authors

LGLoïc GuillevinPCPascal CohenAMAlfred Mahr

Discussion

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Member takes

Overview

May warrant 12 cyclophosphamide pulses over 6 to reduce relapses in severe PAN/MPA; extends RCT data on optimal induction duration.

Structured PICO

Does 12 cyclophosphamide pulses compared to 6 pulses reduce relapses and/or deaths in patients with severe polyarteritis nodosa and microscopic polyangiitis?

P
Population
65 previously untreated patients (18 polyarteritis nodosa [PAN], 47 microscopic polyangiitis [MPA]) with severe disease (≥1 factor of severity according to the five factor score [FFS]) without virus infection.
I
Intervention
12 cyclophosphamide (CY) pulses combined with corticosteroids (CS), administered every 2 weeks for 1 month, then every 4 weeks.
C
Comparator
6 cyclophosphamide (CY) pulses combined with corticosteroids (CS), administered every 2 weeks for 1 month, then every 4 weeks.
O
Outcome
Number of events (relapses and/or deaths)composite

In patients with severe PAN and MPA, 12 cyclophosphamide pulses combined with corticosteroids significantly reduced relapses and improved event-free survival compared to 6 pulses.

Cite This Study

Guillevin et al. (2003) studied this question.

synapsesocial.com/papers/6a72885fe5469ee92be27325https://doi.org/10.1002/art.10922
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