{"id":"https://openalex.org/W2149377741","doi":"https://doi.org/10.7326/0003-4819-109-11-863","title":"Cyclosporin A in Severe, Treatment-Refractory Rheumatoid Arthritis","display_name":"Cyclosporin A in Severe, Treatment-Refractory Rheumatoid Arthritis","publication_year":1988,"publication_date":"1988-12-01","ids":{"openalex":"https://openalex.org/W2149377741","doi":"https://doi.org/10.7326/0003-4819-109-11-863","mag":"2149377741","pmid":"https://pubmed.ncbi.nlm.nih.gov/3190040"},"language":"en","primary_location":{"id":"doi:10.7326/0003-4819-109-11-863","doi":"https://doi.org/10.7326/0003-4819-109-11-863","is_oa":false,"landing_page_url":"https://doi.org/10.7326/0003-4819-109-11-863","pdf_url":null,"source":{"id":"https://openalex.org/S119722071","display_name":"Annals of Internal Medicine","issn_l":"0003-4819","issn":["0003-4819","1539-3704"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316812","host_organization_name":"American College of Physicians","host_organization_lineage":["https://openalex.org/P4310316812"],"host_organization_lineage_names":["American College of Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of Internal Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5051936450","display_name":"David E. Yocum","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1299303238","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88","country_code":"US","type":"government","lineage":["https://openalex.org/I1299022934","https://openalex.org/I1299303238"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"David E. Yocum","raw_affiliation_strings":["National Institutes of Health, Bethesda, Maryland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Institutes of Health, Bethesda, Maryland","institution_ids":["https://openalex.org/I1299303238"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113763662","display_name":"John H. Klippel","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"John H. Klippel","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112204211","display_name":"R L Wilder","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ronald L. Wilder","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":null,"display_name":"Naomi L. Gerber","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Naomi L. Gerber","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113059950","display_name":"H A Austin","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Howard A. Austin","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5035673687","display_name":"Sharon M. Wahl","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Sharon M. Wahl","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":null,"display_name":"Lawrence Lesko","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lawrence Lesko","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110395548","display_name":"James R. Minor","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"James R. Minor","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5047768346","display_name":"Harry G. Preuss","orcid":"https://orcid.org/0000-0002-9170-4913","observed_orcids":["https://orcid.org/0000-0002-9170-4913"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Harry G. Preuss","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045735984","display_name":"Cheryl H. Yarboro","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Cheryl Yarboro","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":null,"display_name":"Carole Berkebile","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Carole Berkebile","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":null,"display_name":"Suanne Dougherty","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Suanne Dougherty","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":8.6157,"has_fulltext":false,"cited_by_count":120,"citation_normalized_percentile":{"value":0.98298267,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":94},"biblio":{"volume":"109","issue":"11","first_page":"863","last_page":"869"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10200","display_name":"Rheumatoid Arthritis Research and Therapies","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10200","display_name":"Rheumatoid Arthritis Research and Therapies","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11616","display_name":"Autoimmune and Inflammatory Disorders Research","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13026","display_name":"Natural Compounds in Disease Treatment","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2707","display_name":"Complementary and alternative medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cyclosporine","display_name":"cyclosporine","score":0.9959999918937683},{"id":"https://openalex.org/keywords/rheumatoid-arthritis","display_name":"rheumatoid arthritis","score":0.9610000252723694},{"id":"https://openalex.org/keywords/treatment-refractory-arthritis","display_name":"treatment-refractory arthritis","score":0.8420000076293945},{"id":"https://openalex.org/keywords/dose-comparison","display_name":"dose comparison","score":0.4819999933242798},{"id":"https://openalex.org/keywords/nephrotoxicity","display_name":"nephrotoxicity","score":0.8989999890327454},{"id":"https://openalex.org/keywords/drug-toxicity","display_name":"drug toxicity","score":0.6209999918937683},{"id":"https://openalex.org/keywords/lymphocyte-proliferative-response","display_name":"lymphocyte proliferative response","score":0.7009999752044678},{"id":"https://openalex.org/keywords/disease-activity","display_name":"disease activity","score":0.7129999995231628},{"id":"https://openalex.org/keywords/synovitis","display_name":"synovitis","score":0.6629999876022339},{"id":"https://openalex.org/keywords/immunosuppressive-therapy","display_name":"immunosuppressive therapy","score":0.8370000123977661},{"id":"https://openalex.org/keywords/adverse-effects-management","display_name":"adverse effects management","score":0.4480000138282776},{"id":"https://openalex.org/keywords/hypertrichosis","display_name":"hypertrichosis","score":0.7620000243186951},{"id":"https://openalex.org/keywords/fatigue","display_name":"fatigue","score":0.9269999861717224},{"id":"https://openalex.org/keywords/gastrointestinal-complaints","display_name":"gastrointestinal problems","score":0.9070000052452087},{"id":"https://openalex.org/keywords/serum-creatinine","display_name":"serum creatinine","score":0.6869999766349792}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9754444360733032},{"id":"https://openalex.org/C2777575956","wikidata":"https://www.wikidata.org/wiki/Q187255","display_name":"Rheumatoid arthritis","level":2,"score":0.8133463859558105},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.6906450986862183},{"id":"https://openalex.org/C142424586","wikidata":"https://www.wikidata.org/wiki/Q7307572","display_name":"Refractory (planetary science)","level":2,"score":0.6618133783340454},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6183897852897644},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.4723202884197235},{"id":"https://openalex.org/C198451711","wikidata":"https://www.wikidata.org/wiki/Q327657","display_name":"Rheumatology","level":2,"score":0.44782862067222595},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.438848614692688},{"id":"https://openalex.org/C2777077863","wikidata":"https://www.wikidata.org/wiki/Q170990","display_name":"Arthritis","level":2,"score":0.42893195152282715},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4251863360404968},{"id":"https://openalex.org/C121332964","wikidata":"https://www.wikidata.org/wiki/Q413","display_name":"Physics","level":0,"score":0.0},{"id":"https://openalex.org/C87355193","wikidata":"https://www.wikidata.org/wiki/Q411","display_name":"Astrobiology","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001172","descriptor_name":"Arthritis, Rheumatoid","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D001172","descriptor_name":"Arthritis, Rheumatoid","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D001172","descriptor_name":"Arthritis, Rheumatoid","qualifier_ui":"Q000276","qualifier_name":"immunology","is_major_topic":false},{"descriptor_ui":"D002097","descriptor_name":"C-Reactive Protein","qualifier_ui":"Q000187","qualifier_name":"drug effects","is_major_topic":false},{"descriptor_ui":"D003404","descriptor_name":"Creatinine","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D003524","descriptor_name":"Cyclosporins","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":false},{"descriptor_ui":"D003524","descriptor_name":"Cyclosporins","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":false},{"descriptor_ui":"D003524","descriptor_name":"Cyclosporins","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D004305","descriptor_name":"Dose-Response Relationship, Drug","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004311","descriptor_name":"Double-Blind Method","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004341","descriptor_name":"Drug Evaluation","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007674","descriptor_name":"Kidney Diseases","qualifier_ui":"Q000139","qualifier_name":"chemically induced","is_major_topic":false},{"descriptor_ui":"D007963","descriptor_name":"Leukocytes, Mononuclear","qualifier_ui":"Q000187","qualifier_name":"drug effects","is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009422","descriptor_name":"Nervous System Diseases","qualifier_ui":"Q000139","qualifier_name":"chemically induced","is_major_topic":false},{"descriptor_ui":"D011446","descriptor_name":"Prospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011897","descriptor_name":"Random Allocation","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.7326/0003-4819-109-11-863","doi":"https://doi.org/10.7326/0003-4819-109-11-863","is_oa":false,"landing_page_url":"https://doi.org/10.7326/0003-4819-109-11-863","pdf_url":null,"source":{"id":"https://openalex.org/S119722071","display_name":"Annals of Internal Medicine","issn_l":"0003-4819","issn":["0003-4819","1539-3704"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316812","host_organization_name":"American College of Physicians","host_organization_lineage":["https://openalex.org/P4310316812"],"host_organization_lineage_names":["American College of Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of Internal Medicine","raw_type":"journal-article"},{"id":"pmid:3190040","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/3190040","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of internal medicine","raw_type":"Clinical Trial"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Randomized Controlled Trial","id":"https://openalex.org/study-designs/randomized-controlled-trial"},{"display_name":"Clinical Trial","id":"https://openalex.org/study-designs/clinical-trial"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":30,"referenced_works":["https://openalex.org/W1526559523","https://openalex.org/W1975886694","https://openalex.org/W1979900185","https://openalex.org/W1982899585","https://openalex.org/W1984175568","https://openalex.org/W1986778299","https://openalex.org/W1989696275","https://openalex.org/W1999786335","https://openalex.org/W2004175072","https://openalex.org/W2005861330","https://openalex.org/W2016446407","https://openalex.org/W2030172858","https://openalex.org/W2031877589","https://openalex.org/W2049359604","https://openalex.org/W2053235019","https://openalex.org/W2062162902","https://openalex.org/W2076343819","https://openalex.org/W2080387207","https://openalex.org/W2089456281","https://openalex.org/W2128965382","https://openalex.org/W2139949747","https://openalex.org/W2149193880","https://openalex.org/W2167855531","https://openalex.org/W2172011800","https://openalex.org/W2321199594","https://openalex.org/W2341778376","https://openalex.org/W2429196804","https://openalex.org/W2429542833","https://openalex.org/W4231271763","https://openalex.org/W4249342726"],"related_works":["https://openalex.org/W2167855531","https://openalex.org/W2465542594","https://openalex.org/W2154787313","https://openalex.org/W2412891926","https://openalex.org/W7099566869","https://openalex.org/W2089456281","https://openalex.org/W2394638015","https://openalex.org/W2268652082","https://openalex.org/W1989696275","https://openalex.org/W2409775299"],"abstract_inverted_index":{"STUDY":[0],"OBJECTIVE:":[1],"To":[2],"assess":[3],"the":[4,61,95,100,157,164,213,260,268],"efficacy":[5],"and":[6,131,174,194,246,249],"toxicity":[7],"of":[8,72,120,134,166,232,276],"cyclosporin":[9,55,220],"A":[10,56,58,221,285],"in":[11,60,87,118,132,150,156,163,185,204,212,225,259,267,274],"patients":[12,26,74,122,136,226,278],"with":[13,33,227,256,263],"severe,":[14,291],"treatment-refractory":[15,292],"rheumatoid":[16,31,293],"arthritis.":[17,294],"DESIGN:":[18],"Prospective":[19],"randomized,":[20],"double-blind":[21],"6-month":[22],"trial.":[23],"PATIENTS:":[24],"Thirty-one":[25],"who":[27,75],"had":[28],"classic":[29],"seropositive":[30],"arthritis":[32],"active":[34],"synovitis":[35],"unresponsive":[36],"to":[37,45,97,126,139,172,180,192,201,219,237,281],"conventional":[38],"therapy.":[39,57],"INTERVENTIONS:":[40],"Patients":[41],"were":[42,93,153,161,222,251],"randomly":[43],"assigned":[44],"high-dose":[46,129,158,214],"(10":[47],"mg/kg":[48],"body":[49],"weight.d)":[50],"or":[51,84],"low-dose":[52,142],"(1":[53],"mg/kg.d)":[54],"reduction":[59,86,258],"dose":[62],"was":[63,207,272],"permitted":[64],"for":[65,102,290],"adverse":[66],"side":[67],"effects.":[68],"After":[69],"6":[70,105,112],"months":[71,211],"therapy,":[73],"showed":[76],"clinically":[77,114],"relevant":[78,115],"improvement,":[79],"defined":[80],"as":[81,182,184,243],"a":[82,257,264],"40%":[83],"greater":[85],"their":[88],"total":[89],"joint":[90],"activity":[91,206],"score,":[92],"given":[94],"option":[96],"continue":[98],"receiving":[99,128,141],"therapy":[101,130,143,289],"an":[103,287],"additional":[104],"months.":[106],"MEASUREMENTS":[107],"AND":[108],"MAIN":[109],"RESULTS:":[110],"At":[111],"months,":[113],"improvement":[116],"occurred":[117],"10":[119],"15":[121],"(95%":[123],"CI,":[124,170,178,190,199],"38":[125],"88)":[127],"4":[133],"16":[135],"(CI,":[137,279],"7":[138],"52)":[140],"(P":[144],"=":[145],"0.02).":[146],"Statistically":[147],"significant":[148],"improvements":[149],"individual":[151],"measures":[152],"shown":[154],"only":[155],"group.":[159,215],"Improvements":[160],"noted":[162],"number":[165],"tender":[167],"joints":[168,176],"(-18.8;":[169],"-24.5":[171],"-13.1)":[173],"swollen":[175],"(-12.1;":[177],"-15.4":[179],"-8.6),":[181],"well":[183],"physician's":[186],"global":[187,196],"scores":[188,197],"(-1.5;":[189],"-2.1":[191],"-0.9)":[193],"patient's":[195],"(-1.1;":[198],"-1.9":[200],"-0.5).":[202],"Improvement":[203],"disease":[205],"maintained":[208],"through":[209],"12":[210],"The":[216],"clinical":[217],"responses":[218,231],"most":[223],"evident":[224],"depressed":[228],"in-vitro":[229],"proliferative":[230],"peripheral":[233],"blood":[234],"mononuclear":[235],"lymphocytes":[236],"soluble":[238],"recall":[239],"antigens.":[240],"Toxicities,":[241],"such":[242],"fatigue,":[244],"gastrointestinal":[245],"neurologic":[247],"complaints,":[248],"hypertrichosis":[250],"frequent":[252],"but":[253],"often":[254],"reversible":[255],"dose.":[261],"Nephrotoxicity,":[262],"20%":[265],"increase":[266],"serum":[269],"creatinine":[270],"level,":[271],"seen":[273],"27":[275],"31":[277],"71":[280],"97).":[282],"CONCLUSIONS:":[283],"Cyclosporin":[284],"is":[286],"effective":[288],"Side":[295],"effects,":[296],"particularly":[297],"nephrotoxicity,":[298],"are":[299],"common.":[300]},"counts_by_year":[{"year":2023,"cited_by_count":1},{"year":2018,"cited_by_count":1},{"year":2015,"cited_by_count":1},{"year":2013,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}
