In which rheumatic diseases is cyclophosphamide therapy indicated? How effective is it?
- • Granulomatosus with polyangiitis (Wegener’s).
- • SLE (particularly lupus nephritis, severe manifestations).
- • ILD in systemic sclerosis patients.
- • Other systemic vasculitis syndromes.
- • Other rheumatic diseases refractory to conventional therapy.
Cyclophosphamide is considered to be one of the most potent immunosuppressive drugs available. Its use has succeeded in almost all rheumatic diseases, particularly when other less potent and usually less toxic forms of therapy have failed. Once remission is induced by cyclophosphamide (usually by 3–6 months), less toxic agents, such as AZA or MMF, are used for maintenance.