US consensus guidelines for the use of cyclosporin A in rheumatoid arthritis

John J. Cush, Peter Tugwell, Michael Weinblatt, David Yocum

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that often leads to irreversible joint damage and loss of function. Although there are numerous treatment options, it is difficult to manage the disease in most patients. Use of cyclosporin A (CsA) for RA was first reported in 1979, and since that time many trials have investigated CsA use for this disease. Based on clinical evidence, CsA is an efficacious second-line agent for patients with active RA who have not responded adequately to methotrexate (MTX). In addition, CsA has been shown to provide clinical benefit when used in combination with MTX in patients responding inadequately to MTX monotherapy. Side effects associated with CsA treatment are manageable if dosing, monitoring, and intervention guidelines are followed. The purpose of this review is to provide recommendations for the use of CsA in severe RA to physicians experienced in the management of systemic immunosuppressive therapy for RA. Where possible and appropriate, recommendations are based on evidence available in the literature.

Original languageEnglish (US)
Pages (from-to)1176-1186
Number of pages11
JournalJournal of Rheumatology
Issue number5
StatePublished - Jan 1 1999
Externally publishedYes


  • Cyclosporine
  • Practice guidelines
  • Review
  • Rheumatoid arthritis
  • United States

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology


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