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© 1993 British Society for Rheumatology

research-article

COMPARISON OF PYRITINOL AND AURANOFIN IN THE TREATMENT OF RHEUMATOID ARTHRITIS

E.-M. LEMMEL for the EUROPEAN MULTICENTRE STUDY GROUP*

Staatliches Rheumakrankenhaus 7570 Baden-Baden, Germany

Correspondence to: Correspondence to E.-M. Lemmel

The efficacy and tolerability of pyritinol (PY) and auranofin (AU) were compared in a multicentre double-blind study. Patients with RA received 600 mg/day PY or 6 mg/day AU for 1 year. Response was rated by a defined improvement in at least four of the following: Ritchie index, joint swelling index, rating scales for pain and general well-being, functional index, morning stiffness, ESR.

Of the 139 fully evaluable PY patients 61 (44%) dropped out due to adverse events or response failure compared with 44 (31 %) of the 142 AU patients. In patients treated for 1 year efficacy parameters improved more in the PY than in the AU group, with significant differences for the general well-being (P = 0.022), ESR (P = 0.029) and haemoglobin (P = 0.0042). The response rate for PY (61/78 patients, 78%) was significantly superior to AU (58/98 patients, 59% P = 0.009). An intention-to-treat analysis corroborated this result (P = 0.030). Adverse events (AE) occurred in 64% of PY patients and in 58% of AU patients: main AE were mucocutaneous symptoms (PY 36%, AU 23%) and gastrointestinal complaints (PY 30% AU 37%). Single cases of proteinuria, hepatic and haematological abnormalities were noted in both groups.

KEY WORDS: Rheumatoid arthritis, Comparative study, Double-blind study, Disease modifying drugs, Pyritinol, Auranofin

*European Multicentre Study Group, participating centres: Germany-Bad Aibling, Dr P. Heimstaät ({dagger}), Arzt für Innere Medi-zin; Bad Kreuznach, Klinik für Rheumakranke, Prof. Dr R. Dreher, Baden-Baden, Staatl. Rheumakrankenhaus, Prof. Dr E.-M. Lemmel, Dr G. Manz; Berlin, Med. Klinik und Poliklinik der Freien Universitat, Klinikum Charlottenburg, Prof. Dr U. Hopf; Immanuel-Krankenhaus, Dr H. Sorensen, Dr R.-W. Hauer, Bremen, Abteilung für Rheumatologie, Rotes-Kreuz-Krankenhaus, Priv.-Doz. Dr U. Botzenhardt, Dr R. Reemtsen; Duisburg, St.-Barbara-Hospital, Abt. für Rheumatologie, Dr R. Gamp; Emmerich, St. Willibrordus-Spital, Priv.-Doz. Dr W. Kriegel, Dr O. Sangha; Hagen, Ev. Krankenhaus, Rheumatologische Abteilung, Dr W. Liman; Hamburg, Univ.-Kran-kenhaus, Eppendorf, I. Med. Univ.-Klinik, Prof Dr K. Grasedyck; Herne, St. Josefs-Krankenhaus, Rheumaklinik, Dr A. Wittenborg, Dr H.-G. Pott; Ingolstadt, Dr U. Trabert, Arzt für Innere Medizin; Köln, Krankenhaus der Augustinerinnen, Innere Abteilung, Dr D. Mitrenga; Mainz, St. Vincenz- u. Elisabeth-Krankenhaus, Prof. Dr D. Brackertz; München, Med. Poliklinik der Universität, Prof. Dr M. Schattenkirchner, Priv.-Doz. Dr K. Krüger, Dr M. Schmid-Wimmer, Püttlingen, Klinik der Bundesknappschaft, Abteilung für Rheumatologie, Dr H. von Wilmowsky; Ratingen, Evang. Fachkrankenhaus GmbH, Rheumatologische Abteilung, Prof Dr R. Rau, Dr G. Her-born; Tübingen, Med. Universitatsklinik, Innere Medizin II, Prof Dr J. G. Saal; Wiesbaden, Rheumaklinik II, Dr D. Jentsch; Würzburg, Medizinische Poliklinik der Universität, Prof. Dr W. Gross; Juliusspi-tal, Med. Klinik, Prof. Dr I. O. Auer. Great Britain—Cambridge, Addenbrookes Hospital, Rheumatology Research Unit, Dr B. L. Hazleman, Dr A. O. Adebajo; London, King's College Hospital, Dr H. Berry; St Bartholomew's Hospital, Department of Rheumatology, Dr E. C. Huskisson; Manchester, University of Manchester, Rheumatism Research Centre, Dr R. Bernstein. Switzerland—Basel, Bethesda-Spital, Rheuma-Klinik, Dr I. Bahous; La Chaux-de-Fonds, Hôpital Cantonal, PD Dr H. Ott; Zürich, Universitätsspital, Uni-versitäts-Rheumaklinik, Prof Dr F. J. Wagenhäuser, Dr M. Felder, Dr E. Treuer; Zürich, Stadtspital Triemli, Klinik für Rheumatologie, Dr H. Gerber. France—Paris, Hôpital de la Pitié, Service de Rhumato-logie, Prof J. P. Camus, Dr J. Crouzet. Trial co-ordination and monitoring—Dr E. Kraus, Clinical Development, Central Scientific Services, E. Merck, 6100 Darmstadt, Germany, E. Sedman, Medical Department, E. Merck Pharmaceuticals, Alton, Hants. Statistical planning and evaluation—Dr M. Behl, Clinical Documentation and Statistics, E. Merck, 6100 Darmstadt, Germany.


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