Outcomes of patients with rheumatoid arthritis initiated on chrysotherapy or D-penicillamine

Parenteral gold salts and D-penicillamine are drugs sometimes indicated for the treatment of definite or classical rheumatoid arthritis unresponsive to more conservative therapy. The results of controlled trials with these drugs in 1960 and 1973, respectively, have established them as "second line" therapy for RA. These drugs are variously described as "remission-inducing", "disease modifying", or "slow-acting" agents. However, after as much as a quarter century of use in patients with RA, many rheumatologists remain unconvinced that gold or D-penicillamine have long term "remission-inducing" effects on RA. Lipsky and Schreiber outlined the properties of "remission-inducing" drugs and included their ability to reduce clinical and biochemical manifestations of RA and provide protection from erosion of joint interfaces. A retrospective review was performed of the medical records (charts) of patients with RA who were treated in the Rheumatology Clinic at the University Hospital, University of Utah. Patient included in this study were initiated on gold or D-penicillamine between 1972 and 1977. treatment outcomes were characterized from the time of treatment initiation up to January, 1985. The proposal to conduct this chart review was approved by the University of Utah Institutional Review Board.