Prospective six year follow up of patients withdrawn from a randomised study comparing parenteral gold salt and methotrexate

摘要: OBJECTIVE—To confirm the impression of a better outcome patients withdrawn from parenteral gold salt therapy compared with those methotrexate. METHODS—Patients early, active, and erosive RA were randomised for double blind trial to receive either weekly 15 mg intramuscular methotrexate or 50 mg goldsodiumthiomalate. If drug had be because side effects treatment was continued other in still active disease. Patients insufficient response treated combination both drugs. All followed up by an extended clinical radiographic evaluation. RESULTS—64 each allocated treatment. After 72 months complete record available 88% patients. Within first 36 months 38 patients withdrew (95% effects) 23 patients (57% effects). A significant 40% 70% improvement all parameters (erythrocyte sedimentation rate, C reactive protein, swollen tender joints, radiological progression) baseline observed completing their methotrexate. The same over three years seen who treatment, while withdrawing experienced deterioration disease. CONCLUSION—Withdrawals represent majority long term trials. early stopping show almost sustained as continuing experience reactivation