ANTI-RHEUMATIC DRUGS AND JOINT DAMAGE IN RHEUMATOID-ARTHRITIS

Abstract

The effect of 2nd-line antirheumatic drugs such as Au on the course and progression of joint damage has been the subject of considerable controversy. The effects of 2nd-line antirheumatic drugs in 3 studies of 46-84 patients with rheumatoid arthritis given a 2nd-line drug continuously for 12 mo. were evaluated. Using 2 different methods of ratiographic assessment it was found that there was significant progression over the 12 mo. period when the mean changes in the groups of patients were examined, and there was similar indication of continuing disease activity shown by mean values of acute phase proteins and ESR which were above the normal range at both 6 and 12 mo. However, there were subgroups of patients who showed a reduction in ESR and joint tenderness with a related slowing of the rate of radiographic progression in the second 6 mo. of treatment. There was no direct relationship between changes in the ESR and radiographic progression in individual patients. Although antirheumatic drugs are not ideal and therapy does not cause remission in many patients, some patients respond well. Rheumatoid arthritis may represent a heterogeneous collection of patients who respond individually to different drugs.