title: Radiological progression in rheumatoid arthritis: do D-penicillamine and hydroxychloroquine have different effects?
abstract: We studied 43 patients with active rheumatoid disease of less than 4 years' duration: 23 were given hydroxychloroquine and 20 penicillamine. Efficacy was assessed using clinical and laboratory variables. Radiological progression was measured using Larsen's method for scoring plain radiographs of the hands and feet. Twenty-four patients received 2 years' continuous therapy. Clinically both drugs were effective with falls in articular index and C-reactive protein. Initial radiological damage was less with penicillamine (P less than 0.05 by Wilcoxon rank sum test). By 2 years there were no significant differences between the two drugs; mean increases in Larsen score were 20.3 with penicillamine and 27.5 with hydroxychloroquine. Both groups progressed at a rate likely to give severe joint destruction over 10-20 years.
authors.affiliation: Department of Rheumatology, St Bartholomew's Hospital, West Smithfield, London.
authors.forename: D L
authors.initials: DL
authors.lastname: Scott
authors.forename: A
authors.initials: A
authors.lastname: Greenwood
authors.forename: J
authors.initials: J
authors.lastname: Davies
authors.forename: P J
authors.initials: PJ
authors.lastname: Maddison
authors.forename: M C
authors.initials: MC
authors.lastname: Maddison
authors.forename: N D
authors.initials: ND
authors.lastname: Hall
mesh_terms: D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D002986:Clinical Trials as Topic; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009068:Movement; D010396:Penicillamine / Q000627:therapeutic use*; D011859:Radiography; D014953:Wrist / Q000000981:diagnostic imaging
chemical_list: D006886:Hydroxychloroquine; D002097:C-Reactive Protein; D010396:Penicillamine