QJM, Vol 89, Issue 1 15-23, Copyright © 1996 by Oxford University Press
E Reinhold-Keller, K De Groot, H Rudert, B Nolle, M Heller and WL Gross
We prospectively studied trimethoprim/sulfamethoxazole (T/S) in inducing
remission in 'initial phase' Wegener's granulomatosis (WG), and in
sustaining remission in generalized WG, in 72 patients in various disease
stages. Nineteen patients with initial phase WG received T/S (2 x 960
mg/day). Another 24 patients with generalized WG received the same dose of
T/S (group A) and were compared with 21 patients receiving no further
treatment after standard therapy (group B). Eight patients were given T/S
plus low-dose prednisone (group C). Eleven of 19 patients (58%) with
initial phase WG achieved complete or partial remission lasting a median 43
months (range 6-88 months). Of the remaining eight (42%), five showed local
disease progression, and three developed generalized WG. In group A (T/S
alone, generalized WG), 10/24 (42%) suffered a relapse after a median 13
months (range 4-58 months). In group B (generalized WG, no further
treatment) 29% of patients relapsed after a median 22.5 months (range 18-26
months). All eight patients treated with T/S plus low-dose prednisone
(group C) suffered serious relapse after 2-24 months. T/S induced long-term
remission in > 50% of patients with initial phase WG; however, neither
T/S alone nor T/S plus low-dose prednisone sustained remission in
generalized WG.
ORIGINAL PAPERS
Response to trimethoprim/sulfamethoxazole in Wegener's granulomatosis depends on the phase of disease
Department of Clinical Rheumatology, Medical University at Lubeck, Germany.
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