Prospidine versus methotrexate pulse in highly active rheumatoid arthritis: A controlled 6-month clinical trial

Abstract

Twenty-seven patients with highly active, refractory rheumatoid arthritis (RA) were treated with the new anti-rheumatic drug prospidine, in view of selecting the optimum pulse regimen and comparing its short-term use with methotrexate (MTX). Prospidine was administered intravenously 500 mg every 3-5 days in the hospital and then monthly. Fifteen patients received MTX (30 mg/week intravenously in hospital and then monthly. Fifteen patients received MTX (30 mg/week intravenously in hospital and then orally 7.5-15 mg/week). The randomisation code was 2:1. We assessed 7 clinical and 4 lab data. The clinical improvement was noticed statistically after 2-4 weeks in 85% prospidine-patients and sustained up to 6 months in 73% (cp. 40% and 57% by the MTX). Only in the prospidine patients were a significant reduction of the mean daily prednisolone dose and the levels of rheumatoid factor and immune complexes observed. Prospidine and MTX had a similar incidence of side effects (39% and 43%), but all drop-outs in prospidine pulse were due to lack of response (26%) and to initial intolerance (4%). Drop-outs in MTX pulse were connected both with drug toxicity (14%) and with lack of response (7%). Alternate prospidine pulse, as highly anti-inflammatory, rapidly acting and well-tolerated regimen, may be used in treating severe forms of RA.

Monotreatment With Conventional Antirheumatic Drugs or Glucocorticoids in Rheumatoid Arthritis

“…A total of 29 interventions among 132 randomized clinical trials (RCTs) represented by 130 publications (mean [range], 71.0% [27.0%-100%] females in studies; mean [range] of ages in studies, 53 [36-70] years) were identified, which included 13 260 patients with rheumatoid arthritis. The number of studies with measured outcomes was 118 studies for TJC, 116 studies…”

“…Figure 1 shows a flowchart of the identification of the pool of RCTs. We included 131 publications, which represented 133 studies. In 1 study, the 2 interventions (sulfapyridine and 5-aminosalicylic acid) were not connected to the network.…”

“…For our primary analysis of all 132 studies (represented by 130 publications) we used the most frequently reported outcome, TJC. This included imputed TJC values for studies that did not measure TJC (eMethods 5 in Supplement 1), denominated TJCi.…”

Dispirotripiperazine-core compounds, their biological activity with a focus on broad antiviral property, and perspectives in drug design (mini-review)

“…[ 25 ]; [ 26 ]; [ 27 ]; [ 28 ]; [ 29 ]; [ 30 ]; [ 31 ]; [ 32 ]; [ 33 ]; [ 34 ]; [ 35 ]; [ 36 ]; [ 37 ]; [ 38 ]; [ 39 ]; [ 40 ]; [ 41 ]; [ 42 ]; [ 50 ]; [ 51 ]; [ 81 ]; [ 82 ]; [ 83 ].…”

A specific dispiropiperazine derivative that arrests cell cycle, induces apoptosis, necrosis and DNA damage

“…One of which is prospidium chloride. This compound, also known as prospidine, has cytostatic, anti-in ammatory and immuno-suppressive properties [11][12][13] . It has been classi ed as an anti-neoplastic compound based on its ability to inhibit T and B cell mitogenesis during lymphoblastic transformation 11 , and to lower tumor volumes of carcinogen-induced mammary tumors in rats 12 .…”