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Correspondence
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Volume 333:1567-1569 December 7, 1995 Number 23
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Cyclosporine and Methotrexate for Severe Rheumatoid Arthritis

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 by Kamel, O. W.
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 by Tugwell, P.
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To the Editor: Tugwell et al. (July 20 issue)1 found that "patients with severe rheumatoid arthritis and only partial responses to methotrexate had clinically important improvement after combination therapy with cyclosporine and methotrexate." We are concerned about the manner in which the cyclosporine doses were adjusted. No mention of the patients' serum cyclosporine levels was made. Determination of serum cyclosporine levels might have allowed a better understanding of the results with respect to therapeutic serum ranges of this medication.

The authors state that people with rheumatoid arthritis "have a risk of cancer 20 to 30 times higher than people in . . . [Full Text of this Article]

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