Clinical study
Immunosuppressive and corticosteroid therapy of polyarteritis nodosa

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Abstract

The clinical manifestations, treatment and survival of 64 patients with polyarteritis nodosa seen from 1955 to 1977 were evaluated. In general, the patients had multisystem involvement. No patient with cutaneous vasculitis alone was accepted into the study. The clinical diagnosis was confirmed by biopsy in 34 patients, by autopsy in 13 and by angiography in 10. The patients were treated at the discretion of the physicians responsible for their care. Eight of the 64 patients received only supportive therapy (group 1), 34 received corticosteroids alone (group 2), and 22 received both corticosteroids and an immunosuppressive agent (group 3). Five patients in group 2 and one patient in group 3 were excluded from survival studies because of insufficient length of therapy. Patients in the three treatment groups were very similar with respect to 18 clinical and laboratory variables. Median survival times for the three groups were three months, 63 months and 149 months, respectively; 5 year survival rates were 12 per cent, 53 per cent and 80 per cent (p < 0.05). Despite difficulty in precisely defining polyarteritis nodosa, the data suggest a better prognosis for treated patients than has previously been appreciated, with improvement in outcome when an immunosuppressive agent is added to corticosteroid therapy.

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  • Cited by (0)

    This study was supported in part by USPHS Grant GM 15759, the Southern California Chapter of the Arthritis Foundation, and the Thomas and Dorothy Leavey Trust.

    Recipient of Southern California Chapter of the Arthritis Foundation Fellowship. Present address: 388 Pearl Street, Burlington, Vermont 05401.

    1

    From the Department of Medicine, UCLA Center for the Health Sciences and Wadsworth Veterans Hospital, Los Angeles, California 90024.

    Present address: 3 Webster Avenue, Jersey City, New Jersey 07307.

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