title: Second line therapy in rheumatoid arthritis--a four year prospective study.
abstract: One hundred and twenty-three rheumatoid patients were commenced on one of the three second-line agents: sodium aurothiomalate (GST), penicillamine (P), or levamisole (L). After four years, 39% of the GST group, 20% of the penicillamine group, and 8% of the levamisole group remained on the original agent. Fifty five % of patients, however, were receiving some second-line agent at four years, and patients showed an improvement in inflammatory indices irrespective of whether or not they were still receiving second-line therapy. It is unclear whether this improvement reflects the natural history of the disease, or the fact that regular clinic attendance identifies patients who require further second-line therapy following cessation of the initial agent.
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001799:Blood Sedimentation; D005500:Follow-Up Studies; D006052:Gold Sodium Thiomalate / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007273:Injections, Intramuscular; D007978:Levamisole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D010396:Penicillamine / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D011897:Random Allocation
chemical_list: D000893:Anti-Inflammatory Agents; D006052:Gold Sodium Thiomalate; D007978:Levamisole; D010396:Penicillamine