Sulphasalazine versus penicillamine in the treatment of rheumatoid arthritis.
Fifty-four patients with rheumatoid arthritis were randomized to either sulphasalazine or D-penicillamine in order to compare the short- and long-term efficacy of these two agents in the treatment of rheumatoid arthritis. Decisive improvement was observed in both treatment groups over a 1 year period. Side effects were common in both groups and accounted for termination of therapy in 11 patients during the first year. Radiological deterioration was evident in both treatment groups. A trend toward greater radiological deterioration was observed in patients receiving sulphasalazine, but this was not statistically significant. Only 11 of the 38 patients who completed 1 year of therapy were continuing to take the same drug 5 years later. Eight patients were continuing D-penicillamine and three were still taking sulphasalazine. Among the patients who completed 1 year of therapy, treatment was subsequently terminated because of loss of effective disease control in a significantly higher proportion of patients receiving sulphasalazine (P less than 0.01). The radiological data and the latter observations suggest that D-penicillamine may be a more effective agent for long-term treatment.
Carroll
G J
GJ
Department of Rheumatic Diseases, Royal Perth (Rehabilitation) Hospital, WA, Australia.
Will
R K
RK
Breidahl
P D
PD
Tinsley
L M
LM
D000123:Acetyltransferases / Q000235:genetics; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000235:genetics; D001175:Arthrography; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use*; D010641:Phenotype; D011897:Random Allocation; D012460:Sulfasalazine / Q000633:toxicity; D013997:Time Factors
D012460:Sulfasalazine; D000123:Acetyltransferases; D010396:Penicillamine