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Titlebook: Rheumatoid Arthritis; The Treatment Contro David H. Goddard,Robin C. Butler Textbook 1984Latest edition Macmillan Publishers Limited 1984 A

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The need for disease-modifying drugsre potentially toxic. Studies to date have indicated that only a small percentage of patients starting treatment with disease-modifying drugs may derive long-term benefit. A high percentage of patients drop out because of adverse reactions. When analysed in terms of cost versus benefit these treatments may be neither effective nor efficient.
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Gold in the treatment of rheumatoid arthritise achieved at a high price in terms of toxicity; even when long-term treatment is attempted, only a minority of patients will remain on treatment after three years. The place of gold salts in the treatment of rheumatoid arthritis needs to be reassessed.
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The need for disease-modifying drugsThis is because there is difficulty in determining which parameters accurately reflect disease activity and disease progression. The Stanford health assessment questionnaire, together with newer radiological techniques, may provide the means by which these assessments can be made..These treatments a
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Gold in the treatment of rheumatoid arthritis reduce symptoms and signs of synovitis and improve patient well-being to a greater extent than placebo. This advantage will persist for one year after injections have been stopped, but can no longer be demonstrated after a further year. There is no compelling evidence that treatment for longer than
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Immunosuppressive therapy for rheumatoid arthritisophos­phamide and chlorambucil (alkylating agents), azathioprine (purine analogue) and methotrexate (folic acid analogue). A Medline search and review articles were used to identify clinical trials of these drugs in patients with rheumatoid arthritis. A scoring system was used to assess the design a
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Conclusionspants, one and all, prescribe one or more of these agents almost every working day of their lives, yet the use of these drugs remains highly controversial. How they should be used — indeed, whether some of them should be prescribed at all — and what studies we should be planning to answer these ques
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Macmillan Publishers Limited 1984
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