Treating Intractable Rheumatoid Arthritis

Abstract

In this issue of the Journal, investigators in Stanford and Boston report that total lymphoid irradiation suppresses joint inflammation in patients with severe rheumatoid arthritis not adequately controlled by standard therapy.^{1 , 2} Evidence of decreased disease activity was noted in most patients within three months after completion of therapy. Morning stiffness, joint swelling, and tenderness continued to wane for another three months. The disease flared in the Boston patients after about a year had elapsed, whereas improvement in the patients treated in California persisted for up to 18 months, although several "transient flares" required an increase in the daily corticosteroid . . .