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Biomedical subjects

M Dougados

Publications and source records attributed to M Dougados.

At least 271 records · Page 15Linked to original sources
PubMed1988

Cyclosporin in rheumatoid arthritis: a double blind, placebo controlled study in 52 patients.

The efficacy and safety of cyclosporin A (CyA) for patients with rheumatoid arthritis were assessed in a four month double blind, placebo controlled study using an initial dosage of 5 mg/kg daily. Six patients withdrew from the study (two in the placebo group because of inefficacy of treatment and four in the CyA group because of side effects). These six patients were considered therapeutic failures. At the end of the trial the study treatment was considered as good or very good by 14 out of the 26 CyA group patients and by only two out of the 26 placebo group patients. Moreover, in the CyA group significant improvement was observed in five of the seven clinical assessment criteria. Clinical improvement was correlated with a decrease in C reactive protein, alpha 1 glycoprotein levels, and platelet count but not with erythrocyte sedimentation rate or rheumatoid factor titres. Renal toxicity (13 cases) remained the major problem in the management of these patients. This study shows that CyA is effective in active rheumatoid arthritis but requires close monitoring for toxicity.

Arthritis, Rheumatoid↗
PubMed1988

Hepatocellular carcinoma after danazol therapy.

Danazol, an inhibitor of pituitary gonadotropin, has been proposed in the treatment of systemic lupus erythematosus (SLE). We report the case of a female patient with SLE in whom a hepatocellular carcinoma was discovered after 4 years of treatment with danazol. Except for 3 days of hypochondrium pain, there were neither clinical signs of liver tumor nor biological abnormalities. An ultrasonography showed 2 tumors of the liver. At histological examination after surgery, one of the tumors was found to be a benign adenoma, while the other was a well differentiated hepatocellular carcinoma. When longterm danazol therapy is required, ultrasonography may be useful for early tumor detection.

Adenoma↗
PubMed1988

Fibrinolysis abnormalities in systemic lupus erythematosus and their relation to vasculitis.

Fibrinolysis was evaluated in 16 women with SLE, who were divided into three groups of increasing disease severity according to their past history, and in 10 normal subjects. Fibrinolysis parameters assessed were tissue-type plasminogen activator (t-PA) activity in plasma and in euglobulin fractions and rapid plasminogen activator inhibitor activity. All parameters were evaluated before and after venous occlusion to assess endothelial cell t-PA release in response to localized anoxia. Markers of deficient fibrinolysis were persistently undetectable t-PA activity and increased rapid plasminogen activator inhibitor activity after venous occlusion. Defective fibrinolysis was correlated with disease severity; it was noted only in patients with severe or moderate disease and in no patients with mild disease or in controls. Fibrinolysis abnormalities were independent of disease activity, suggesting that vascular endothelium injuries occurring during flare-ups persist during inactive phases of the disease. No correlation was found between fibrinolysis abnormalities and disease duration, corticosteroid administration, or the presence of lupus anticoagulant or anticardiolipin antibodies. These data support the hypothesis of parallelism between the severity of vascular injuries, suggested by deficient fibrinolysis, and the severity of clinical manifestations in SLE.

Adult↗
PubMed1988

Evaluation of a functional index and an articular index in ankylosing spondylitis.

We describe an index of functional impairment and a system of scoring joint tenderness for use in the assessment of ankylosing spondylitis. The functional index consists of 20 questions and the articular index is based on the scoring of a total of 10 joint responses after movement or firm digital pressure. These indices are simple to establish and not time consuming. They have a high degree of intra- and interobserver reproducibility. The indices showed changes in short term clinical trials of antiinflammatory drugs; these changes were highly correlated with the patient's overall assessment of his own clinical condition.

Activities of Daily Living↗
PubMed1987

Cyclosporin A in rheumatoid arthritis: preliminary clinical results of an open trial.

Twelve patients with refractory rheumatoid arthritis were included in a 1-year open trial of cyclosporin A (CsA), 5 mg/kg/day. Clinical efficacy was observed 1 month after beginning treatment, was well established after 4 months of therapy, and remained stable for the remainder of the 1-year treatment period. Among the numerous side effects observed, renal toxicity and hypertension occurred suddenly during the trial and required constant monitoring, adequate therapy, and modulation of CsA dosage. Cyclosporin A seems to be an effective treatment for active rheumatoid arthritis, but it requires close monitoring for toxicity.

Adult↗
PubMed1987

Nonathymulin in rheumatoid arthritis: two double blind, placebo controlled trials.

Two randomised double blind, placebo controlled trials have been carried out to assess the effectiveness of nonathymulin, a synthetic thymic peptide hormone, in the treatment of rheumatoid arthritis (RA) and to compare three different dosage schedules (1, 5, and 10 mg/day). Nonathymulin 5 mg proved to be the most efficient dose, providing significant clinical improvement as evaluated by the global assessment of all patients who entered the trials (56% v 17% in the placebo group) (p less than 0.02) and by four objective parameters. This effect was accompanied with minimal adverse effects and was not associated with clear changes in immunological parameters. A significant correlation was observed, however, in clinical response to nonathymulin, and T cell subset imbalance was assessed using monoclonal anti-T cell antibodies and a functional suppressor T cell assay.

Arthritis, Rheumatoid↗
PubMed1987

[Treatment of ankylosing spondylitis with salazosulfapyridine. A controlled double-blind study in 60 patients].

The efficacy of salazosulfapyridine (SI) has been recently reported in the course of peripheral arthritis in ankylosing spondylarthritis (SPA), but is action on the axial forms of the disease was not known. We have therefore conducted a therapeutic trial in 60 patients suffering from SPA, without peripheral involvement clinical sign evoking an enterocolopathy. This double-blind study compared the activity of SI at a dose of 2 g/day with a placebo, for 6 months. Thirteen patients had to discontinue the treatment: 6 in the placebo group (inefficacy: 3 cases, anemia: 1 case, epigastric pain: 1 case, rash: 1 case) and 7 cases in the SI group (inefficacy: 2 cases, nauseous: 3 cases, abdominal pain: 1 case, moderate elevation of transaminases: 1 case). These 13 patients were kept for the global analysis and considered as therapeutic failures. The treatment was considered effective in 15 out of 30 patients of group SI and in 30 patients on placebo (p less than 0.02). In addition, in group SI, a statistically significant decrease of the daily dose of non-steroid anti-inflammatory drugs was observed (-6.5 +/- 7.2 versus -2.4 +/- 6.4 in the placebo group, p less than 0.05); also was observed a decrease of the functional index (-5.9 +/- 6.6 versus -1.9 +/- 5.7 in the group placebo, p less than 0.05) and of the serum level of immunoglobulin G (-1.8 +/- 3.6 g/l versus +0.8 +/- 2.9 in the placebo group, p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Value of dapsone in the treatment of rhizomelic pseudopolyarthritis and Horton's disease].

In 11 patients suffering from polymyalgia rheumatica or Horton's disease, dapsone was associated with corticotherapy because of corticosteroid side effects (11 cases) and/or progression of the disease despite relatively high dose steroid therapy (6 cases). This treatment had to be discontinued in 4 patients because of side effects and in 3 patients because of a recurrence of the disease. Despite these numerous withdrawals, dapsone seems to be of clinical benefit in these patients because of 1) the mildness of the side effects observed in this study, 2) its efficacy evaluated on the improvement of clinical signs of the disease and, overall, on the decrease in the corticosteroid consumption.

Aged↗
PubMed1987

[Systematic ileocolonoscopy in seronegative spondylarthropathies].

An inflammation of the ileum was observed by Mielants and Veys in patients suffering from reactional arthritis associated to HLA B27 antigen. We thought it would be interesting to perform a systematic ileo-colonoscopy in patients suffering from seronegative spondylo-arthropathy, whether it was an axial or a peripheral form of the disease, or it was associated or not to HLA B27 antigen. The results observed in 30 patients who responded to the criteria of Wright and Moll for the diagnosis of seronegative spondylo-arthropathy, were compared to those of 18 patients suffering from various gastro-intestinal disorders. Macroscopically, a minimal abnormality (erythematous patches and/or micro-ulcerations) was observed in 10 out of 30 patients, and never in the reference group (p less than 0.02). The histological examination demonstrated, in patients suffering from spondylarthritis, a higher frequency of minimal signs of inflammation (lympho-plasmocytes infiltration) at the level of the ileum (in 18 out of 19 patients versus 11 out of 18 patients in the reference group, p less than 0.05) and at the level of the rectum (in 15 out of 19 patients, versus 8 out of 17 patients in the reference group, p less than 0.05). This study suggests therefore the presence of minimal ileorectal inflammation in patients with seronegative spondylo-arthritis, which could have an influence on the pathogenesis and/or the evolutive course of the disease.

Colonoscopy↗
PubMed1987

[Erythrocyte sedimentation rate and serum immunoglobulins in rheumatic pelvispondylitis].

Blood sedimentation rate and balanced titration of immunoglobulins were studied in 59 patients presenting a ankylosing pelvispondylitis: in 30 of them, these examinations were repeated at an interval of 3-6 months. The sedimentation rate (Sed. rate) and the level of immunoglobulins G and A increased in the course of the disease, but an elective increase of the level of immunoglobulins A was not demonstrated. Neither the Sed. rate, nor the level of IgA are correlated to evolution criteria of the disease; a positive correlation is only found with the platelets number, in a vertical study of 59 patients. Nevertheless, the variations of the immunoglobulins A is positively correlated with alterations of the clinical condition as demonstrated in the longitudinal study carried out in 30 patients. This finding supports physiopathological hypothesis which incriminates microbial intestinal infections at the origin of evolutive bouts of ankylosing pelvispondylitis.

Arthritis, Rheumatoid↗
PubMed1987

[Ankylosing spondylarthritid and Berger's disease. A fortuitous association?].

Fifteen cases of ankylosing spondylarthritis, associated to an IgA nephropathy have been reported in the literature. This association may be fortuitous, or on the contrary suggest a common pathogenic link between the two diseases and the authors have compared the incidence of radiological abnormalities of the sacro-iliac joints as well as the incidence of rheumatoid clinical signs in 186 patients suffering from an IgA nephropathy to those observed in 192 reference patients. This study could not demonstrate any difference between the two groups and, therefore, suggests that the cases reported in the literature are secondary to a simple fortuitous association.

Adolescent↗
PubMed1986

Sulphasalazine in ankylosing spondylitis: a double blind controlled study in 60 patients.

Sulphasalazine has been reported to be effective in ankylosing spondylitis with peripheral arthritis, but its efficacy in spondylitis is unknown. Thus 60 patients with active ankylosing spondylitis without peripheral arthritis or gastrointestinal symptoms were randomly allocated to one of two therapeutic groups. One group received 2 g sulphasalazine daily for six months and the other a placebo. Thirteen patients (six given placebo and seven given sulphasalazine) dropped out of the trial and were considered to be treatment failures. After six months' follow up efficacy was rated as good or very good by 15 of the 30 patients given sulphasalazine and by only six of the 30 given placebo (p less than 0.02). Furthermore, in the patients given sulphasalazine the daily consumption of non-steroidal anti-inflammatory drugs, functional index, and plasma IgG concentrations had fallen significantly. These data suggest that sulphasalazine may be a safe and effective treatment for spondylitis in ankylosing spondylitis.

Clinical Trials as Topic↗