© 1986 British Society for Rheumatology
research-article |
A PROSPECTIVE FIVE-YEAR COMPARISON OF TREATMENT WHICH INCLUDED PENICILLAMINE WITH THAT EXCLUDING PENICILLAMINE IN EARLY RHEUMATOID ARTHRITIS
Correspondence to:
Address correspondence to Dr. W. H. Lyle
Seventy-three patients with early, active rheumatoid arthritis (RA) were randomly allocated either to a group that received penicillamine or to a control group from which penicillamine was barred, any other second-line drug being permitted. Most (87%) of the controls received chrysotherapy at some stage. Clinical, serological and radiographic progress was observed for at least 5 years. Outcome after 5 years for the 27 remaining in the penicillamine group was compared with that for the 23 surviving controls. Both groups had improved clinically but deteriorated radiographically, with much individual variation. A subset of patients, mostly seronegative, who were radiographically normal at the outset remained so, regardless of treatment. Penicillamine was as effective as the control group treatments in relieving synovitis and as ineffective in arresting radiographic deterioration.
KEY WORDS: Penicillamine, Rheumatoid arthritis, Radiography
*E. G. L. Bywaters, Royal Postgraduate Medical School, London; A. V. Camp, Wycombe General Hospital; A. T. Day, J. R. Golding, Royal Bath Hospital, Harrogate; A. M. Freeman, D. N. Golding, Princess Alexandra Hospital, Harlow; C. L. Greenbury, A. G. S. Hill, H. F. H. Hill and M. Webley, Stoke Mandeville Hospital, Aylesbury; I. M. Koch, Dista Products; W. H. Lyle, 7 Astley Close, Leamington Spa, Warwickshire; K. MacRae, Charing Cross Hospital Medical School, London; A. J. Swannell, City Hospital, Nottingham.