Article Text

Download PDFPDF
Second line (disease modifying) treatment in rheumatoid arthritis: which drug for which patient?
  1. H A Capell,
  2. D R Porter,
  3. R Madhok,
  4. J A Hunter
  1. Centre for Rheumatic Diseases, Glasgow Royal Infirmary, United Kingdom.


    OBJECTIVES--The objectives were to assess (a) the comparative merits of commonly used disease modifying drugs in the treatment of rheumatoid arthritis (RA) and (b) the influence of age, gender, and disease duration on the outcome of treatment. METHODS--Collected analysis (meta-analysis) was performed on results obtained during the first year of treatment in 1140 patients with RA treated with gold, penicillamine, sulphasalazine, or auranofin from a single centre. RESULTS--Gold, penicillamine, and sulphasalazine performed similarly, with about 60% of patients continuing to receive each of these drugs for at least one year. Neither gender nor age had an influence on the response to treatment, but patients with a longer disease duration showed a greater tendency to stop treatment. The median percentage improvement was 33% in visual analogue pain score and 50% in erythrocyte sedimentation rate. CONCLUSIONS--Routine use of these drugs should at least equal these results. Any new drug should either be substantially less toxic or at least as efficacious.

    Statistics from

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.