title: A study of the combined effect of ACTH(gel) and D-penicillamine on the functional disability of patients with rheumatoid disease.
abstract: Over a 6-year period, in 48 patients given concomitant D-penicillamine and ACTH(gel), the rapid induction of remission of the rheumatoid disease as judged by return to work in full and gainful employment was achieved in 77% within 1 month, in 71% by the end of 3 years, by which time 89% had achieved either Steinbrocker functional class I or II. Side effects were strikingly low in our patients with this regime, except for nephrotoxicity (10%); skin rash, dysgeusia and thrombocytopenia in 1 patient only and all patients were free of any gastrointestinal upset. Subsequent treatment of the failures with gold produced an overall remission rate of 90% in 3 years.
mesh_terms: D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010396:Penicillamine / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D005782:Gels; D000324:Adrenocorticotropic Hormone; D010396:Penicillamine