Proresid therapy in rheumatoid arthritis. A comparison with injectable gold using life-table analysis.
Proresid, mainly consisting of podophyllotoxin derivatives and two glycosides thereof, has been used as a disease-modifying antirheumatic drug in Sweden since the late 1960s. A life-table analysis of Proresid treatment averaging 41 months (range 4-144) in 79 rheumatoid arthritis patients showed a termination rate of 40, 56, 75 and 85% after 1/2, 1, 2 and 4 years, respectively. Dominant reasons for discontinuing therapy were inefficacy (37%) and gastrointestinal symptoms (35%). The risk of discontinuation of therapy due to inefficacy was constant over time, while the risk due to other causes, including side effects, gradually decreased. A comparison with injectable gold therapy showed, after adjusting for confounding factors, that the total termination incidence was higher (p < 0.05) in the Proresid-treated patients. A comparison with the regional cancer register of 334 patients exposed to Proresid for a mean time of 2.2 years showed no increased cancer risk after a mean observation time of 6.1 years.
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Department of Rheumatology, Sahlgren University Hospital, Göteborg, Sweden.
Bjelle
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006046:Gold / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007267:Injections; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology; D010349:Patient Compliance; D010352:Patient Dropouts; D011033:Podophyllin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011034:Podophyllotoxin / Q000031:analogs & derivatives; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
C003170:mitopodozide; D006046:Gold; D011033:Podophyllin; D011034:Podophyllotoxin