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. 1994 Dec;53(12):812–815. doi: 10.1136/ard.53.12.812

Outcome of second line therapy in rheumatoid arthritis.

D R Porter 1, I McInnes 1, J Hunter 1, H A Capell 1
PMCID: PMC1005481  PMID: 7864689

Abstract

OBJECTIVES--To study the functional outcome in patients with rheumatoid arthritis (RA) who tolerate second line drug therapy for five years. METHODS--We enrolled into prospective controlled trials, 190 patients with rheumatoid arthritis who tolerated 'disease modifying' antirheumatic drug therapy for five years. Demographic data were recorded. Disease activity was measured every six months for two years and annually thereafter, using clinical and laboratory variables. Patient function was measured using the modified Health Assessment Questionnaire. The change in each variable was analysed using paired Wilcoxon tests. RESULTS--Patient function improved significantly compared with baseline. The improvement was maximal after one to two years, and thereafter function started to decline slowly. After five years of treatment the patients' function was still significantly better than before treatment had started. There were highly significant improvements in all variables measured to assess disease activity, which remained well controlled throughout the five year period. CONCLUSION--Good control of disease activity and improved function can be achieved long term in approximately 30% of RA patients treated with injectable gold, sulphasalazine or penicillamine.

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Selected References

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  1. Bendix G., Bjelle A. Outcome of parenteral gold therapy in RA patients: a comparison between two periods using life-table analysis. Br J Rheumatol. 1991 Dec;30(6):407–412. doi: 10.1093/rheumatology/30.6.407. [DOI] [PubMed] [Google Scholar]
  2. Capell H. A., Lewis D., Carey J. A three year follow up of patients allocated to placebo, or oral or injectable gold therapy for rheumatoid arthritis. Ann Rheum Dis. 1986 Sep;45(9):705–711. doi: 10.1136/ard.45.9.705. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Capell H. A., Marabani M., Madhok R., Torley H., Hunter J. A. Degree and extent of response to sulphasalazine or penicillamine therapy for rheumatoid arthritis: results from a routine clinical environment over a two-year period. Q J Med. 1990 Apr;75(276):335–344. [PubMed] [Google Scholar]
  4. Capell H. A., Murphy E. A., Hunter J. A. Rheumatoid arthritis: workload and outcome over 10 years. Q J Med. 1991 Jun;79(290):461–476. [PubMed] [Google Scholar]
  5. Epstein W. V., Henke C. J., Yelin E. H., Katz P. P. Effect of parenterally administered gold therapy on the course of adult rheumatoid arthritis. Ann Intern Med. 1991 Mar 15;114(6):437–444. doi: 10.7326/0003-4819-114-6-437. [DOI] [PubMed] [Google Scholar]
  6. Grindulis K. A., McConkey B. Outcome of attempts to treat rheumatoid arthritis with gold, penicillamine, sulphasalazine, or dapsone. Ann Rheum Dis. 1984 Jun;43(3):398–401. doi: 10.1136/ard.43.3.398. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Jones E., Jones J. V., Woodbury J. F. Response to sulfasalazine in rheumatoid arthritis: life table analysis of a 5-year followup. J Rheumatol. 1991 Feb;18(2):195–198. [PubMed] [Google Scholar]
  8. Lehtinen K., Isomäki H. Intramuscular gold therapy is associated with long survival in patients with rheumatoid arthritis. J Rheumatol. 1991 Apr;18(4):524–529. [PubMed] [Google Scholar]
  9. Madhok R., Zoma A., Torley H. I., Capell H. A., Waring R., Hunter J. A. The relationship of sulfoxidation status to efficacy and toxicity of penicillamine in the treatment of rheumatoid arthritis. Arthritis Rheum. 1990 Apr;33(4):574–577. doi: 10.1002/art.1780330416. [DOI] [PubMed] [Google Scholar]
  10. McConkey B., Amos R. S., Durham S., Forster P. J., Hubball S., Walsh L. Sulphasalazine in rheumatoid arthritis. Br Med J. 1980 Feb 16;280(6212):442–444. doi: 10.1136/bmj.280.6212.442. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Porter D. R., Capell H. A., Hunter J. Combination therapy in rheumatoid arthritis--no benefit of addition of hydroxychloroquine to patients with a suboptimal response to intramuscular gold therapy. J Rheumatol. 1993 Apr;20(4):645–649. [PubMed] [Google Scholar]
  12. Porter D. R., Capell H. A. The 'natural' history of active rheumatoid arthritis over 3-6 months--an analysis of patients enrolled into trials of potential disease-modifying anti-rheumatic drugs, and treated with placebo. Br J Rheumatol. 1993 Jun;32(6):463–466. doi: 10.1093/rheumatology/32.6.463. [DOI] [PubMed] [Google Scholar]
  13. Pullar T., Capell H. A. A rheumatological dilemma: is it possible to modify the course of rheumatoid arthritis? Can we answer the question? Ann Rheum Dis. 1985 Feb;44(2):134–140. doi: 10.1136/ard.44.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Pullar T., Hunter J. A., Capell H. A. Effect of acetylator phenotype on efficacy and toxicity of sulphasalazine in rheumatoid arthritis. Ann Rheum Dis. 1985 Dec;44(12):831–837. doi: 10.1136/ard.44.12.831. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Pullar T., Hunter J. A., Capell H. A. Sulphasalazine in the treatment of rheumatoid arthritis: relationship of dose and serum levels to efficacy. Br J Rheumatol. 1985 Aug;24(3):269–276. doi: 10.1093/rheumatology/24.3.269. [DOI] [PubMed] [Google Scholar]
  16. Scott D. L., Symmons D. P., Coulton B. L., Popert A. J. Long-term outcome of treating rheumatoid arthritis: results after 20 years. Lancet. 1987 May 16;1(8542):1108–1111. doi: 10.1016/s0140-6736(87)91672-2. [DOI] [PubMed] [Google Scholar]
  17. Sigler J. W., Bluhm G. B., Duncan H., Sharp J. T., Ensign D. C., McCrum W. R. Gold salts in the treatment of rheumatoid arthritis. A double-blind study. Ann Intern Med. 1974 Jan;80(1):21–26. doi: 10.7326/0003-4819-80-1-21. [DOI] [PubMed] [Google Scholar]
  18. Situnayake R. D., Grindulis K. A., McConkey B. Long-term treatment of rheumatoid arthritis with sulphasalazine, gold, or penicillamine: a comparison using life-table methods. Ann Rheum Dis. 1987 Mar;46(3):177–183. doi: 10.1136/ard.46.3.177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. van der Heijde D. M., van Riel P. L., Nuver-Zwart I. H., Gribnau F. W., vad de Putte L. B. Effects of hydroxychloroquine and sulphasalazine on progression of joint damage in rheumatoid arthritis. Lancet. 1989 May 13;1(8646):1036–1038. doi: 10.1016/s0140-6736(89)92442-2. [DOI] [PubMed] [Google Scholar]

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