Use of Cyclophosphamide by the i.v. Route in Systemic Rheumatic Diseases, inParticular in Systemic Lupus Erythematosus

Overview

The author summarizes briefly the basic features of the therapeutic action of the alkylatingsubstance, cyclophosphamide, in autoimmune diseases. On the example of lupus nephritis heinvestigated the development: administration of this substance from the oral continuous form tothe present intermittent intravenous administration, and gives the reasons which eventually led toits introduction as a certain standard. The author evaluates all other attempts to apply thistherapeutic regime not only in systemic lupus erythematosus but also in other diseases of this typesuch as polymyositis/dermatomyositis, diffuse scleroderma, some forms of systemic vasculitis,Behçet’s disease, and finally rare attempts in primary and secondary forms of Sjögren’s syndrome.In all these diseases the procedure proved useful in particular in serious pulmonary complicationsorwhen the central nervous system was affected. All mentioned experience is based on internationalreferences, most frequently from 1990–2001. The author mentions also some important detailsduring administration including contraindications and undesirable toxic effects.

Key words:
cyclophosphamide, i.v. pulsed form, lupus nephritis, systemic rheumatic diseases