The efficacy and toxicity of daily, oral cyclosporin A (CSA) in active rheumatoid arthritis patients who have failed or developed toxicity to conventional therapies and have been off cytotoxic therapy for at least 3 months will be evaluated in a 6 month double-blind study of low dose vs high dose CSA. Toxicity will be monitored weekly for the first 2 months and then every 2 weeks until 6 months. Disease activity will be assessed on a bi-monthly basis. Patients who do not develop at least a 40% improvement in disease activity at 6 months will be dropped from the study, while those with a 40% or greater response will continue indefinitely.
