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Thabet MM, Huizinga TW. Dapsone, penicillamine, thalidomide, bucillamine, and the tetracyclines. Rheumatology (Oxford) 2011. [DOI: 10.1016/b978-0-323-06551-1.00056-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Abstract
In their 60-year history, dapsone and the sulfones have been used as both antibacterial and anti-inflammatory agents. Dapsone has been used successfully to treat a range of dermatologic disorders, most successfully those characterized by abnormal neutrophil and eosinophil accumulation. This article reviews and updates the chemistry, pharmacokinetics, clinical application, mechanism of action, adverse effects, and drug interactions of dapsone and the sulfones in dermatology.
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Affiliation(s)
- Y I Zhu
- Department of Dermatology, New York Presbyterian Medical Center, 161 Fort Washington Ave., New York, NY 10032, USA
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Abstract
Dapsone, a synthetic sulfone with chemical similarities to sulfapyridine, has been used for a number of years to treat leprosy and dermatitis herpetiformis. Recently, a number of prospective, randomized, double-blind trials have shown their success in the management of rheumatoid arthritis, with dapsone being superior to placebo and comparable to chloroquine and hydroxychloroquine. Its mode of anti-inflammatory actions in rheumatoid arthritis is not clearly understood, but modulation of neutrophil activity or inhibition of neutrophil inflammatory product formation or release appear to play a role. The major limiting side effect is hemolytic anemia, which may be mitigated through careful patient selection, conservative drug dosing, close monitoring, and possibly, concurrent administration of antioxidants or cytochrome P450 inhibitors. Methemoglobinemia is another common finding among patients receiving dapsone therapy, but rarely does it result in prominent symptoms other than transient pallor. Less common adverse events to dapsone include the idiosyncratic reactions of leukopenia and agranulocytosis, cutaneous eruptions, peripheral neuropathy, psychosis, toxic hepatitis, cholestatic jaundice, nephrotic syndrome, renal papillary necrosis, severe hypoalbuminemia without proteinuria, an infectious mononucleosis-like syndrome, and minor neurological and gastrointestinal complaints. In this report, two patients with advanced rheumatoid arthritis, who were safely and effectively treated with dapsone after failure with other second-line agents, are described and the literature is reviewed. We suggest that dapsone is an effective second-line agent in the treatment of rheumatoid arthritis.
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Affiliation(s)
- D J Chang
- Division of Rheumatology and Connective Tissue Research, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School 08903-0019, USA
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McConkey B, Amos RS, Butler EP, Crockson RA, Crockson AP, Walsh L. Salazopyrin in rheumatoid arthritis. 1978. AGENTS AND ACTIONS 1994; 43:202-5. [PMID: 7725973 DOI: 10.1007/bf01986689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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5
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Sulphasalazine and aminosalicylates in rheumatoid and related arthropathies. Inflammopharmacology 1993. [DOI: 10.1007/bf02660624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Haar D, Sølvkjaer M, Unger B, Rasmussen KJ, Christensen L, Hansen TM. A double-blind comparative study of hydroxychloroquine and dapsone, alone and in combination, in rheumatoid arthritis. Scand J Rheumatol 1993; 22:113-8. [PMID: 8316771 DOI: 10.3109/03009749309099254] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Eighty patients with active rheumatoid arthritis (RA) entered a double-blind randomized study of 24 weeks duration, to compare the efficacy and toxicity of hydroxychloroquine, dapsone, and a combination of both drugs in treatment of RA. Evaluation of changes in clinical, laboratory and radiologic variables was based on 63 patients completing the trial. There was no clear difference between the three therapy groups in most inflammatory variables after 24 weeks. However, only patients receiving the combination therapy improved significantly in all clinical and laboratory variables. Nine patients in the combination group and four in each single drug group discontinued during the trial, mainly because of toxicity. Four patients taking the combination therapy withdrew because of hemolytic anemia, and none in the dapsone group. These findings suggest that hydroxychloroquine in combination with dapsone is somewhat more effective and less tolerated than single drug treatments.
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Affiliation(s)
- D Haar
- Department of Rheumatology, Kong Christian Xth Gigthospital, Graasten, Denmark
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7
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Pullar T. Disease modifying drugs for rheumatoid arthritis: yesterday's treatment today or today's treatment tomorrow? Br J Clin Pharmacol 1990; 30:501-10. [PMID: 2291864 PMCID: PMC1368239 DOI: 10.1111/j.1365-2125.1990.tb03807.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- T Pullar
- Department of Medicine, University of Leeds
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Abstract
Thirteen patients with recurrent severe widespread recalcitrant bullous pemphigoid (BP) were studied. These patients had been initially treated with prednisone and azathioprine, and clinically responded. However, they frequently continued to have flare-ups or activation of the disease while still on treatment with high doses of these drugs. The addition of dapsone, as an adjuvant to the treatment, helped to produce a complete clinical remission in 12 patients (92%). In addition, there was a statistically significant difference in the median dose of prednisone, before and after the institution of dapsone, and in the maintenance dose of prednisone. Patients were tapered off prednisone more easily than before and did not flare at lower doses of prednisone as previously. It is suggested that, in patients with severe, recalcitrant, recurrent disease, the addition of dapsone to the existing regime of corticosteroids and/or immunosuppressive drugs, may be beneficial. This may be especially valuable to patients in whom corticosteroids have been used for prolonged periods and in whom increasing the corticosteroid dose further may be associated with significant side-effects.
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Abstract
Sulphasalazine (salicyl-azo-sulphapyridine) has been in clinical use for over 40 years. Although the drug was originally introduced for the treatment of 'rheumatic polyarthritis' and ulcerative colitis, it is only in the past 10 years that its value in rheumatology has been appreciated. Controlled studies indicate that the drug is an effective remittive agent in both rheumatoid arthritis and ankylosing spondylitis. This is an area of great research interest since the drug is proving to be a useful tool for investigating the aeteology and pathogenesis of these diseases.
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Affiliation(s)
- A J Taggart
- Department of Therapeutics and Pharmacology, Queen's University of Belfast, Northern Ireland
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Fredenberg MF, Malkinson FD. Sulfone therapy in the treatment of leukocytoclastic vasculitis. Report of three cases. J Am Acad Dermatol 1987; 16:772-8. [PMID: 3571541 DOI: 10.1016/s0190-9622(87)70100-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Dapsone therapy for leukocytoclastic (necrotizing) vasculitis has been little used, except for the variant forms of erythema elevatum diutinum and urticarial vasculitis. We report three patients with the common (palpable purpura) form of the disease, limited to the skin, and successfully treated with moderate doses of dapsone (100-150 mg daily). Although the natural course of leukocytoclastic vasculitis is highly unpredictable, the prompt disappearance of new lesion formation after initiation of treatment and the rapid recurrence of lesions after therapy is discontinued (both often within 4 to 8 days after the critical dose level is reached) reflect drug efficacy. We believe that dapsone deserves wider evaluation as a therapeutic agent for chronic or recurrent cases of the common form of leukocytoclastic vasculitis.
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Hunneyball IM, Crossley MJ, Spowage M. Pharmacological studies of antigen-induced arthritis in BALB/c mice. II. The effects of second-line antirheumatic drugs and cytotoxic agents on the histopathological changes. AGENTS AND ACTIONS 1986; 18:394-400. [PMID: 2875633 DOI: 10.1007/bf01965003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The effects of treatment with second-line antirheumatic drugs and cytotoxic agents on the severity of experimental monoarticular arthritis in BALB/c mice have been investigated. The arthritis was assessed histologically in terms of synovitis and erosions of cartilage and bone. Azathioprine (20 mg/kg) and sulphasalazine (10-30 mg/kg oral; 30-100 mg/kg i.p.) produced significant suppression of synovitis and erosions when administered daily for 4 weeks commencing 2 weeks after induction of the arthritis. Dapsone (1-10 mg/kg) and to a lesser extent methotrexate (2 mg/kg) produced some suppression of erosive disease when administered daily for 4 weeks commencing 2 weeks after induction of the arthritis but this failed to reach statistical significance. Chloroquine, D-penicillamine and sodium aurothiomalate all failed to have any effect on the disease with any of the treatment schedules used. Auranofin had no effect on the disease when treatment commenced 2 weeks after intra-articular injection but produced variable suppression at high doses when administered from the day of intra-articular injection.
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Situnayake RD, McConkey B. Which component of sulphasalazine is active in rheumatoid arthritis? BRITISH MEDICAL JOURNAL 1985; 291:138. [PMID: 2861878 PMCID: PMC1416264 DOI: 10.1136/bmj.291.6488.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Hosie GAC, Hosie J. "Failure" of the random zero sphygmomanometer in general practice. BMJ : BRITISH MEDICAL JOURNAL 1985. [DOI: 10.1136/bmj.291.6488.137-d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dobbin AE. Hepatitis B virus DNA in saliva, urine, and seminal fluid of carriers of hepatitis B e antigen. BMJ : BRITISH MEDICAL JOURNAL 1985; 291:138-9. [PMID: 3926086 PMCID: PMC1416237 DOI: 10.1136/bmj.291.6488.138-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Shen TY. Chemistry and Biological Profile of Immunosuppressants. Pharmacology 1985. [DOI: 10.1007/978-1-4615-9406-2_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jeffes EW, Kaplan RP, Ahmed AR. Acantholysis producedin vitro with pemphigus serum: Hydrocortisone inhibits acantholysis, while dapsone and 6-mercaptopurine do not inhibit acantholysis. J Clin Immunol 1984; 4:359-63. [PMID: 6541659 DOI: 10.1007/bf00917138] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Many studies have shown that human skin in organ cultures containing pemphigus antibody undergoes acantholysis, the histologic hallmark of pemphigus vulgaris. This in vitro organ culture system provides a good model to determine if drugs used to treat pemphigus inhibit the effect of pemphigus antibody after it is produced. In this study we determined if hydrocortisone, dapsone, and 6-mercaptopurine (6-MP) could inhibit acantholysis observed in human skin organ cultures containing high constant levels of pemphigus plasma. In six experiments we demonstrated that hydrocortisone (10(-3) and 5 X 10(-4) M) present at the start of organ culture inhibited acantholysis induced by pemphigus sera. Thus, this study raises the possibility that the large doses of steroids used to treat acute pemphigus could act directly on the skin, inhibiting acantholysis in the presence of high titers of pemphigus antibody. Other effective immunosuppressive drugs, such as dapsone and 6-MP, probably do not act directly on the skin.
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Fowler PD, Shadforth MF, Crook PR, Lawton A. Report on chloroquine and dapsone in the treatment of rheumatoid arthritis: a 6-month comparative study. Ann Rheum Dis 1984; 43:200-4. [PMID: 6370150 PMCID: PMC1001465 DOI: 10.1136/ard.43.2.200] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A controlled study compared 6 months' treatment of 60 patients with rheumatoid arthritis (RA). Half were randomly allocated to treatment with chloroquine 250 mg daily, the other half dapsone 100 mg daily (50 mg/day for the first 7 days) following a one-month run-in assessment period. All patients had active or progressing disease. Both treatment groups showed significant improvement in morning stiffness, number of painful joints, pain scores, Ritchie index, and proximal interphalangeal joint size, and the chloroquine group alone in grip strength. Laboratory tests showed significant decreases in erythrocyte sedimentation rate, C-reactive protein, and total serum protein levels, with significant increase in serum albumin in the dapsone group, where there was a significant mean drop in haemoglobin (less than 1 g/dl) and a rise in serum bilirubin, associated with its haemolytic effect. X-ray erosion scores were not significantly affected. The clinical and laboratory responses became evident by the time of the 2-month assessment. Criteria for clinical and laboratory improvement were defined, according to which there were 21/26 improvers in the chloroquine group and 12/29 in the dapsone group. It is concluded that although both are effective preparations, chloroquine showed a significantly higher improvement rate and was certainly better tolerated. It is the preferred treatment for patients with active or progressive disease not controlled by nonsteroidal anti-inflammatory drugs, with dapsone as an alternative for patients who fail to respond to or cannot tolerate chloroquine.
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Scott DL, Grindulis KA, Struthers GR, Coulton BL, Popert AJ, Bacon PA. Progression of radiological changes in rheumatoid arthritis. Ann Rheum Dis 1984; 43:8-17. [PMID: 6696524 PMCID: PMC1001208 DOI: 10.1136/ard.43.1.8] [Citation(s) in RCA: 136] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A prospective study over one year of patients who had active rheumatoid arthritis discovered 64 who had received treatment for an adequate time with second-line drugs. In these patients there was evidence of continuing joint destruction as shown by radiological progression. During the year there were highly significant correlations between improvements in clinical and laboratory measurements, but neither group of tests was related to the degree of radiological change. However, in the second 6 months of treatment there was evidence that radiological progression was reduced. In a second prospective study of 88 patients with rheumatoid arthritis given prolonged, intensive therapy with second-line drugs and followed up for 10 years two-thirds showed radiological progression. However, the number of joints damaged per year fell significantly during the study period. There was a divergence between deterioration in radiological features and improvements in the ESR and functional capacity, though patients with a persistently low ESR had less radiological progression. These studies provide evidence that treatment may be associated with a reduced rate of radiological progression but suggest that changes in radiological progression and clinical and laboratory measurements may result from different mechanisms.
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Neumann VC, Grindulis KA, Hubball S, McConkey B, Wright V. Comparison between penicillamine and sulphasalazine in rheumatoid arthritis: Leeds-Birmingham trial. BRITISH MEDICAL JOURNAL 1983; 287:1099-102. [PMID: 6138116 PMCID: PMC1549360 DOI: 10.1136/bmj.287.6399.1099] [Citation(s) in RCA: 100] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Sulphasalazine was first formulated by Svartz in the early 1940s, specifically for use as a remission inducing drug in rheumatoid arthritis. After the publication of an unfavourable trial, however, the drug was restricted to patients with ulcerative colitis. In the late 1970s sulphasalazine was re-examined in rheumatoid arthritis and favourable results reported in "open" trials. A double blind controlled trial was therefore conducted comparing enteric coated sulphasalazine and D-penicillamine in patients with active rheumatoid arthritis. A total of 63 patients were recruited in two centres; 31 were treated with sulphasalazine and 32 received penicillamine. After 16 weeks' treatment both drugs had produced significant improvements in clinical score, pain score measured on a visual analogue scale, grip strength, Ritchie articular index, erythrocyte sedimentation rate, and serum C reactive protein concentration. Nausea was the major side effect in the sulphasalazine treated group. No potentially dangerous effects of sulphasalazine were encountered in contrast with those seen in the penicillamine group. The results suggest that sulphasalazine is an effective and safe drug capable of producing remissions in active rheumatoid arthritis. They also lend confidence to the use of preliminary "open" trials as a means of screening for remission inducing drugs in rheumatoid arthritis.
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Grindulis KA, Calverley M, Constable TJ, Forster PJ, Ahmed ME, McConkey B. A comparison between clinical and laboratory tests in rheumatoid arthritis. Scand J Rheumatol 1983; 12:285-8. [PMID: 6623019 DOI: 10.3109/03009748309098551] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Five clinical measurements (clinical score, articular index, visual analogue pain score, visual analogue function score, grip strength) were compared with two laboratory tests (the erythrocyte sedimentation rate and serum C-reactive protein concentration) in 68 patients with rheumatoid arthritis (RA). Patients treated with nonsteroid anti-inflammatory drugs showed clinical deterioration when treatment was interrupted, followed by improvement on resumption; there was no change in the laboratory tests. Patients treated with remission-inducing drugs (RIDs) had improved clinical measurements and also reduced erythrocyte sedimentation rate and serum C-reactive protein levels. Treatment with RID's led to similar trends in both clinical and laboratory tests, but correlation coefficients between the tests at intervals rarely attained statistical significance. The different response times for each test and probably also errors inherent in clinical measurements introduced sufficient variability to account for the discrepancy. Of the clinical tests, 'clinical score' appeared the most satisfactory.
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Chapter 18. Disease Modifying Anti-Rheumatic Drugs. ANNUAL REPORTS IN MEDICINAL CHEMISTRY 1983. [DOI: 10.1016/s0065-7743(08)60773-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register]
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Scott D, Scott D, Bacon P. Therapeutic progress--review VI. Treatment of rheumatoid arthritis. JOURNAL OF CLINICAL AND HOSPITAL PHARMACY 1982; 7:217-29. [PMID: 6761367 DOI: 10.1111/j.1365-2710.1982.tb01027.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Anti-rheumatic drugs used in rheumatoid arthritis fall into two distinct groups: non-steroidal anti-inflammatory and second-line drugs. Non-steroidal anti-inflammatory drugs give early symptomatic improvement and reduce the degree of acute inflammatory synovitis. Second-line drugs such as gold or D penicillamine exert an anti-inflammatory effect only after two to three months and act by suppressing disease activity: these reduce the ESR and other acute phase responses. However, the evidence that any of these drugs halt the progression of radiological changes or can be used as long-term agents to control the disease over a period of years is weak. The current use of anti-rheumatic drugs follows a general pattern with non-steroidal anti-inflammatory drugs used alone in patients with mild disease, whereas patients with severe disease also receive second-line drugs. As yet the long-term effect of this policy is not known. Cytotoxic drugs should be restricted to patients with severe disease who either fail to respond to conventional second-line drugs or have active extra-articular disease, particularly those with vasculitis.
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Therapeutic workshop on modifying the disease process in rheumatoid arthritis: immunosuppression in perspective. Ann Rheum Dis 1982; 41 Suppl 1:1-60. [PMID: 7065738 PMCID: PMC1030282 DOI: 10.1136/ard.41.suppl_1.1-a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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McConkey B. Adverse reactions to dapsone. Lancet 1981; 2:525. [PMID: 6115268 DOI: 10.1016/s0140-6736(81)90905-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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30
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Swinson DR, Zlosnick J, Jackson L. Double-blind trial of dapsone against placebo in the treatment of rheumatoid arthritis. Ann Rheum Dis 1981; 40:235-9. [PMID: 7018409 PMCID: PMC1000754 DOI: 10.1136/ard.40.3.235] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Dapsone given over 14 weeks in a dose of 50 mg a day for 1 week and thereafter 100 mg a day was found to have a beneficial effect in rheumatoid arthritis when compared with placebo administration to a matched group of patients. Significant improvement in 5 out of 7 clinical measurements and in erythrocyte sedimentation rate, viscosity, C-reactive protein was found in those patients taking dapsone. There was significant improvement compared to the placebo group in 2 out of the 7 clinical measurements and again in all 3 acute-phase reactants. The drug was quite well tolerated over the 14-week duration of the trial. The tendency to cause haemolysis will be its main limiting factor as a practical alternative to other suppressive agents currently in use.
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Amos RS, McConkey B. Non-invasive assessment of drug action in rheumatoid arthritis and related disorders. Pharmacol Ther 1981; 14:477-92. [PMID: 7034006 DOI: 10.1016/0163-7258(81)90039-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Davies P, Bonney RJ, Humes JL, Kuehl FA. The role of macrophage secretory products in chronic inflammatory processes. J Invest Dermatol 1980; 74:292-6. [PMID: 6993572 DOI: 10.1111/1523-1747.ep12543476] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Mononuclear phagocytes participate in various stages of chronic inflammatory responses and associated diseases. Such participation is mediated by (a) direct interaction with pericellular interstitial tissue components as well as with other cell types present at sites of inflammation and (b) by secretion of soluble mediators. Several of these mediators are synthesized and secreted in increased amounts after macrophages interact with inflammatory stimuli. In this paper we pay particular attention to neutral proteinases and prostaglandins. It is shown that these 2 classes of mediators are released in significant amounts under different conditions. Prostaglandins are synthesized most readily by resident populations of mouse peritoneal macrophages responding to various model inflammatory stimuli. Mouse peritoneal macrophage populations elicited in vivo by inflammatory stimuli are less responsive in this respect. In contrast neutral proteinase secretion does not occur in resident cell populations but is observed on a continuous basis in elicited populations. Such secretion can be increased further by addition of phagocytic stimuli and initiated in resident populations by model inflammatory stimuli such as phorbol myritate acetate. Other secretory products of macrophages with possible relevance to inflammation are discussed briefly. Finally some of the effects of antiinflammatory glucocorticoids, cyclooxygenase inhibitors and dapsone on the secretory activity of macrophages are briefly summarized.
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Wright V, Amos R. Do drugs change the course of rheumatoid arthritis? BRITISH MEDICAL JOURNAL 1980; 280:964-6. [PMID: 6106520 PMCID: PMC1601115 DOI: 10.1136/bmj.280.6219.964-a] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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McConkey B, Amos RS, Billingham ME, Constable TJ, Crockson RA, Crockson AP, Forster PJ. Rheumatoid arthritis: effects of a new agent (ICI 55 897) on serum acute phase proteins and the erythrocyte sedimentation rate. Ann Rheum Dis 1980; 39:18-21. [PMID: 6990881 PMCID: PMC1000463 DOI: 10.1136/ard.39.1.18] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Thirty-four patients with rheumatoid arthritis (RA) were treated with a new agent (ICI 55 897) in addition to basic therapy with nonsteroid anti-inflammatory drugs. Five patients had the drug for less than 28 days; the remaining 29 were observed for periods up to a year. At 140 days, when all but 2 patients were in the study, there had been statistically significant improvement in clinical score, serum C-reactive protein, erythrocyte sedimentation rate, and plasma fibrinogen. Thereafter results continued to improve but were biased because some patients had stopped taking the drug. The final conclusion was that 17 patients had improved with 1 late relapse, and 15 had not responded. Adverse effects were trivial except in 2 instances: one patient had a transient unexplained rise in blood urea, another had a haematemesis. Neither effect could be attributed with certainty to the drug. ICI 55 897 has no intrinsic analgesic or anti-inflammatory properties. We suggest the findings of this study indicate that this agent, with low toxicity and the ability to lower acute-phase protein levels, may be an alternative to gold or penicillamine in the treatment of RA.
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Hunneyball IM. Recent developments in disease-modifying antirheumatic drugs. PROGRESS IN DRUG RESEARCH. FORTSCHRITTE DER ARZNEIMITTELFORSCHUNG. PROGRES DES RECHERCHES PHARMACEUTIQUES 1980; 24:101-216. [PMID: 7005959 DOI: 10.1007/978-3-0348-7108-2_4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Gemmell DK, Cottney J, Lewis AJ. Comparative effects of drugs on four paw oedema models in the rat. AGENTS AND ACTIONS 1979; 9:107-16. [PMID: 157060 DOI: 10.1007/bf02024141] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The development of novel anti-inflammatory drugs (AID) has been claimed to be dependent on the discovery of models of inflammation that differ from those currently used for drug screening, e.g. carrageenen paw oedema and u.v. erythema. We have thus evaluated the effect of a variety of drugs in a number of novel models of inflammation in the rat produced in the hind paw. We have utilized kaolin, zymosan, anti-rat IgG (anti-IgG) and the Reversed Passive Arthus (RPA) reaction to produce these oedema models. We found that the non-steroidal AID's, e.g. aspirin, flufenamic acid, indomethacin, naproxen, and phenylbutazone, were active in all four tests. Of the nine novel AID examined, levamisole and tetramisole demonstrated considerable activity in all four tests and dapsone was especially active in the anti-IgG and RPA tests. In contrast, the anti-rheumatic d-penicillamine was inactive in all four models. Each of the ten compounds tested which has been claimed to influence complement function, was active in the RPA but not in the kaolin model. These results are discussed in the context of the aetiology of each oedema and the suspected mode of action of the various drugs.
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Lewis AJ, Gemmell DK, Stimson WH. The anti-inflammatory profile of dapsone in animal models of inflammation. AGENTS AND ACTIONS 1978; 8:578-86. [PMID: 311146 DOI: 10.1007/bf01998887] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Dapsone has been shown to possess anti-inflammatory activity in a variety of animal models. It possesses oral anti-oedema activity especially pronounced in novel models of acute inflammation, viz. anti-IgG and reversed passive Arthus oedemas. However, it is not very active in the guinea pig u.v. erythema model. It is effective in chronic models such as adjuvant arthritis and the cotton pellet granuloma although multiple administration may also produce cyanosis. Antipyretic and analgesic effects for dapsone have been demonstrated and are similar to those produced by phenylbutazone. It inhibits zymosan-induced beta-glucuronidase release from cultured macrophages and also the activity of this enzyme. Dapsone does not appear to be ulcerogenic in the rat.
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McConkey B, Amos RS, Butler EP, Crockson RA, Crockson AP, Walsh L. Salazopyrin in rheumatoid arthritis. AGENTS AND ACTIONS 1978; 8:438-41. [PMID: 28650 DOI: 10.1007/bf01968673] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
After a 12-week preliminary period of observation 32 patients with consistently active rheumatoid arthritis (RA) were treated for up to 22 weeks with salazopyrin. Seven patients could not tolerate the drug. The remaining 25 patients had a marked improvement in subjective clinical state and significant falls in serum C-reactive protein and the erythrocyte sedimentation rate 6 weeks after treatment began. The improvement was maintained after 22 weeks. The results strongly suggest that further trials with this drug in RA are needed.
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Crockson AP, Crockson RA, McConkey B. C-reactive protein in rheumatoid arthritis. ARTHRITIS AND RHEUMATISM 1978; 21:491. [PMID: 656165 DOI: 10.1002/art.1780210415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Greaves MW, Hensby CN, Plummer NA, Warin AP. The effect of short wavelength ultraviolet (C (254 nm), irradiation on arachidonic acid and prostaglandins E2 and F2alpha concentrations in human skin [proceedings]. Br J Pharmacol 1977; 61:445P-446P. [PMID: 588810 PMCID: PMC1667841 DOI: 10.1111/j.1476-5381.1977.tb08439.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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