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. 2000;1998(2):CD001083.
doi: 10.1002/14651858.CD001083.

Cyclosporine for rheumatoid arthritis

G Wells  1 , D Haguenauer, B Shea, M E Suarez-Almazor, V A Welch, P Tugwell
Affiliations

Cyclosporine for rheumatoid arthritis

G Wells et al. Cochrane Database Syst Rev. 2000.

Abstract

Objectives: To estimate the short-term (up to one year) effects of cyclosporine for rheumatoid arthritis.

Search strategy: We searched the Cochrane Musculoskeletal Group trials register, and Medline, up to 1997, using the search strategy developed by the Cochrane Collaboration (Dickersin 1994). The search was complemented with bibliography searching of the reference list of the trials retrieved from the electronic search. Key experts in the area were contacted for further published and unpublished articles.

Selection criteria: All randomized clinical trials (RCTs) and controlled clinical trials (CCTs) comparing cyclosporine against placebo in patients with rheumatoid arthritis.

Data collection and analysis: Two reviewers determined the trials to be included based on inclusion and exclusion criteria (GW, MSA). Data were independently abstracted by two reviewers (DH, GW),and checked by a third reviewer (BS) using a pre-developed form for the rheumatoid arthritis sub-group of the Cochrane Musculoskeletal Group. Methodological quality of the RCTs and CCTs was assessed by two reviewers (BS, DH). Rheumatoid arthritis outcome measures were extracted from the publications for change from baseline endpoints. Sufficient data were obtained to include in the pooled analysis the number of swollen joints, physician global assessment, patient global assessment and erythrocyte sedimentation rate (ESR).

Main results: Three trials and 318 patients were included. A statistically significant decrease in the number of tender and swollen joints was observed for cyclosporine when compared to placebo. The standardized mean difference (SMD) for the change in the number of swollen joints was -0.969. Significant improvements in pain and the functional index were also found for cyclosporine. More side effects occurred in the cyclosporine group compared to placebo.

Reviewer's conclusions: Cyclosporine has an important clinical benefit int the short-term (up to one year) treatment of patients with progressive rheumatoid arthritis.

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Conflict of interest statement

None known.

References

References to studies included in this review

Dougados 1988 {published data only}
    1. Dougados M, Awada H, Amor B. Cyclosporin in rheumatoid arthritis : a double blind, placebo controlled study in 52 patients. Ann Rheum Dis 1998;47:127‐33. - PMC - PubMed
Forre 1994 {published data only}
    1. Forre O and the Norvegian Arthritis Study Group. Radiologic evidence of disease modification in rheumatoid arthritis patients treated with cyclosporine. Arthritis Rheum 1994;37:1506‐12. - PubMed
Tugwell 1990 {published data only}
    1. Tugwell P, Bombardier C, Gent M, et al. Low‐dose cyclosporin versus placebo in patients with rheumatoid arthritis. Lancet 1990;335:1051‐5. - PubMed

References to studies excluded from this review

Van Rijthoven 1986 {published data only}
    1. Rijthoven A, Dijkmans BA, Goei The H, et al. Cyclosporin treatment for rheumathoid arthritis : a placebo controlled, double‐blind, multicenter study. Ann Rheum Dis 1986;45:726‐31. - PMC - PubMed

Additional references

Dickersin 1994
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