TREATMENT OF SYSTEMIC VASCULITIS WITH CYCLOPHOSPHAMIDE AND STEROIDS -DAILY ORAL LOW-DOSE CYCLOPHOSPHAMIDE ADMINISTRATION AFTER FAILURE OF A PULSE INTRAVENOUS HIGH-DOSE REGIMEN IN 4 PATIENTS

The efficacy of cyclophosphamide (CY) in the treatment of severe syste mic vasculitis has been demonstrated, but its optimal administration r egimen remains to be defined. The four patients described participated in prospective therapeutic trials of polyarteritis nodosa (PAN) witho ut hepatitis B infection markers, Churg-Strauss syndrome (CSS) and Weg ener's granulomatosis (WG) and received daily oral low-dose CY after f ailure of a monthly pulse regimen. These patients were included in thi s study because of failure to induce clinical remission (two patients) and relapse during the course of treatment (two patients). The result s were good with initial clinical remission in three patients and stab ilization in one. One patient with WG relapsed 10 months after changin g therapeutics. The advantages of the different administration protoco ls are discussed.