title: [Retrospective study of adverse events in patients with rheumatoid arthritis treated with second-line drugs].
abstract: OBJECTIVE
  To evaluate rates on the adverse side effect and discontinuation of second-line drugs frequently used in the treatment of rheumatoid arthritis (RA).
  
  
  METHODS
  Eight hundred and sixty-four RA patients were studied in a retrospective program.
  
  
  RESULTS
  Upper abdominal discomfort was most commonly seen when using second-line drugs. Rash was often associated with D-penicillamine (20.6%) and Sinomenium therapy (13.7%). Methotrexate (MTX) was uniquely characterized by substantial upper GI toxicity (32.2%) and Tripterygium wilfordii Hook. f. (TWH) (14.4%) by menstrual abnormality. Sulfasalazine users reported adverse events including upper abdominal trouble (39.0%), nausea (7.3%) and anorexia (7.3%) while the risk of GI malaise was greater. Patients taking hydroxychloroquine complained of blurred vision (19.6%) but no one went blind. Toxic side effects seemed to be the most common reasons for stoppages, and the patients taking MTX had the lowest discontinuation rate. Combination of D-penicillamine and Methotrexate did not increase the incidence of adverse events.
  
  
  CONCLUSIONS
  Knowledge on these different patterns of toxicity provided choices in the selection of second line agents for particular RA patients. However, long-term monitor are required when drugs are being used.
authors.affiliation: Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Lindi
authors.initials: L
authors.lastname: Jiang
authors.forename: Naiqing
authors.initials: N
authors.lastname: Zhao
authors.forename: Liqing
authors.initials: L
authors.lastname: Ni
mesh_terms: D000328:Adult; D000855:Anorexia / Q000139:chemically induced; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010396:Penicillamine / Q000009:adverse effects / Q000627:therapeutic use; D008517:Phytotherapy; D028321:Plant Preparations / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D032841:Sinomenium; D012460:Sulfasalazine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D018501:Antirheumatic Agents; D028321:Plant Preparations; D012460:Sulfasalazine; D006886:Hydroxychloroquine; D010396:Penicillamine; D008727:Methotrexate