title: An attempt to predict the response to gold therapy in rheumatoid arthritis.
abstract: In 54 rheumatoid arthritis patients undergoing conventional chrysotherapy, we prospectively sought predictors of response, using strict clinical and laboratory criteria of improvement. Forty-five patients who completed 6-12 months of therapy were classified into 3 outcome categories: group 0, not significantly improved (18 patients); group 1, improved (18 patients); and group 2, markedly improved (9 patients). Sixty-two entry variables were tested in univariate and multivariate analysis for predictor function. No continuous variable was predictive. The discrete variables HLA-A3 positivity and HLA-DR4 negativity were the best predictors of response to gold. In a multivariate analysis using these 2 univariates (A3 and DR4) plus hemoglobin, we developed a discriminant function that correctly predicted outcome in 21 of 23 patients in groups 0 and 2. We also observed that of 15 DR blank patients (10 of whom were DR4 blank), none entered remission.
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006046:Gold / Q000627:therapeutic use* / Q000633:toxicity; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007136:Immunoglobulins; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D006680:HLA Antigens; D007136:Immunoglobulins; D006046:Gold