INTRAVENOUS AND ORAL CYCLOPHOSPHAMIDE PULSE THERAPY IN RHEUMATIC DISEASES - SIDE-EFFECTS AND COMPLICATIONS

Twenty five patients (12 with systemic lupus erythematosus, 6 with Weg ener's granulomatosis, and 7 with miscellaneous rheumatic diseases) wh o had been on intravenous or oral cyclophosphamide pulse therapy for m ore than 3 months were evaluated for safety of treatment. Side effects were reported by 20 patients (80%), mainly nausea (17 patients, 68%). Complications were observed in 13 patients (52%), of whom 6 had sever e infections (24%). Oral cyclophosphamide given in repeated low dose p ulses (5 mg/kg for 3 consecutive days) is better tolerated with regard to nausea than intravenous administration. The use of cyclophosphamid e therapy is recommended in patients with disease that does not respon d to conventional regimens, although the attending physician should be aware that infections may appear at any time during treatment, and ef fective prophylaxis against nausea is required.