RT Journal Article
SR Electronic
T1 Second line (disease modifying) treatment in rheumatoid arthritis: which drug for which patient?
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 423
OP 428
DO 10.1136/ard.52.6.423
VO 52
IS 6
A1 H A Capell
A1 D R Porter
A1 R Madhok
A1 J A Hunter
YR 1993
UL http://ard.bmj.com/content/52/6/423.abstract
AB 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.