Violeta Bojincă *, M. Bonjincă **
* Dr. Violeta Bojincă, asistent universitar UMF “Carol Davila”, Clinica de Medicină Internă,
Spital “Sf. Maria”, București
** Dr. Mihai Bojincă, asistent universitar UMF “Carol Davila”, Clinica de Medicină Internă și
Reumatologie, Spital “Dr. I. Cantacuzino, București
Abstract
Rheumatoid arthritis (RA) in an autoimmune disease characterized by chroinic imllammation of joints (proliferative and erosive synovitis) and multisystem involvement. Both cellular and humeral immune mechanisms contribuite to the initiation and maintenance of rheumatoid inflammation. RA produces significant morbidity and in some cases mortality. Because of this disease modifying antirheumatic drugs (DMARDs) are used earlier in the course of RA. Methotrexate has became the initial DMARD of choice for rheumatologist. Unfortunately with currently available DMARD therapy complete remissions in RA are disappointingly rare and frequently transient. Therefore new agents developed, one of them being Cyclosporine A (CsA), a fungal peptide who has received considerable attention as immunosuppressive agent in preveting and treating rejection in transplant recipients. CsA acts more specificcally on the immune system than the others cytotoxic/ immunosuppressive drugs. The use of CsA in RA must be considered in patients with severe disease non-responding to conventional FMARD treatment (i.e. MTX) or in those who present with early RA and a poor prognosis. The major limitation for CsA is it’s renal toxicity. The use of CsA in combination with other agents (MTX, Hydroxycloroquine, gold salts or even biologic agents) appears very promising. CsA is a potent drug who proved to be extremely useful in certain patients with RA and other autoimmune diseases.