{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T16:17:53Z","timestamp":1781281073974,"version":"3.54.1"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,12,9]],"date-time":"2005-12-09T00:00:00Z","timestamp":1134086400000},"content-version":"vor","delay-in-days":4666,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[1993,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective.<\/jats:italic> To investigate the effectiveness of oral chlorambucil treatment in patients with dermatomyositis (DM) that is recalcitrant to treatment with prednisone and\/or immunosuppressive agents.<\/jats:p><jats:p><jats:italic>Methods.<\/jats:italic> Five patients with recalcitrant DM were treated with oral chlorambucil, 4 mg\/day, after discontinuation of the other immunosuppressive agent (azathioprine or methotrexate). Three patients were treated with a combination of prednisone and chlorambucil, and 2 with chlorambucil alone.<\/jats:p><jats:p><jats:italic>Results.<\/jats:italic> Beneficial effects were noted within 4\u20136 weeks in all 5 patients, and corticosteroids were eventually discontinued in 4. Currently, only 1 patient is still receiving therapy; the other 4 have stopped chlorambucil after 13\u201330 months of treatment, and their disease remains in remission. Minimal chlorambucil toxicity was noted, consisting of leukopenia in 2 patients.<\/jats:p><jats:p><jats:italic>Conclusion.<\/jats:italic> Our findings suggest that chlorambucil is an effective, corticosteroid\u2010sparing agent for the control of DM.<\/jats:p>","DOI":"10.1002\/art.1780360305","type":"journal-article","created":{"date-parts":[[2007,2,15]],"date-time":"2007-02-15T00:46:54Z","timestamp":1171500414000},"page":"319-324","source":"Crossref","is-referenced-by-count":64,"title":["Chlorambucil"],"prefix":"10.1002","volume":"36","author":[{"given":"Patricia A.","family":"Sinoway","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Callen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,12,9]]},"reference":[{"key":"e_1_2_1_2_2","volume-title":"Dermatomyositis, Dermatological Signs of Internal Disease","author":"Callen JP","year":"1988"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-198937030-00007"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1985.tb05834.x"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(84)80263-7"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780280523"},{"key":"e_1_2_1_7_2","first-page":"658","article-title":"Combined steroid, methotrexate and chlorambucil therapy for steroidresistant dermatomyositis","volume":"9","author":"Cagnoli M","year":"1991","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197502132920706"},{"key":"e_1_2_1_9_2","first-page":"1214","article-title":"The treatment of dermatomyositis with hydroxychloroquine","volume":"12","author":"James WD","year":"1985","journal-title":"J Rheumatol"},{"key":"e_1_2_1_10_2","first-page":"3","article-title":"Immunosuppressive and cytotoxic drugs: uses in the dermatology patient","volume":"5","author":"Callen JP","year":"1990","journal-title":"Adv Dermatol"},{"key":"e_1_2_1_11_2","volume-title":"Cytotoxic agents, Systemic Drugs for Skin Diseases","author":"Rapini RP","year":"1991"}],"container-title":["Arthritis &amp; Rheumatism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.1780360305","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.1780360305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T05:06:44Z","timestamp":1700716004000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.1780360305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,3]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1993,3]]}},"alternative-id":["10.1002\/art.1780360305"],"URL":"https:\/\/doi.org\/10.1002\/art.1780360305","archive":["Portico"],"relation":{},"ISSN":["0004-3591","1529-0131"],"issn-type":[{"value":"0004-3591","type":"print"},{"value":"1529-0131","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,3]]}}}