Can we develop simple response criteria for slow acting antirheumatic drugs?

Article Abstract:

The evaluation of the treatment of rheumatoid arthritis (RA) with slow-acting antirheumatic drugs (SAARDs) depends on multiple clinical and laboratory measures, which are analyzed separately. However, a single classification of response is preferable for clinical practice and therapeutic trials. Patients who were given either penicillamine or sulfasalazine were evaluated every three to six months for a total of 12 months, to determine their response to the drug. The response ranged from no change to remission of disease. Six months was found to be the optimal time to classify the response, as most changes had occurred by this time. Eleven clinical and laboratory measures were evaluated. An index of response was determined based on four of the 11 measures that showed the greatest change and gave the most information. The standards that were used were the following: erythrocyte sedimentation rate of less than 30 mm/hour, articular index of less than 3; morning stiffness for less than 15 minutes; and 50 percent reduction in joint pain. Both penicillamine and sulfasalazine gave similar results. This measurement of response rate is simple, sensitive, specific, and suitable for use in clinical practice and drug studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Joints, Joints (Anatomy), Sulfasalazine

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Survival analysis of disease modifying antirheumatic drugs in Spanish rheumatoid arthritis patients

Article Abstract:

Methotrexate, gold salts and azathioprine may be the most well tolerated drugs for the long-term treatment of patients with rheumatoid arthritis (RA). Researchers analyzed the drug treatment histories of 629 patients with RA. Half of the patients taking methotrexate continued taking the drug for more than 50 months. Half of the patients taking either gold salts or azathioprine continued taking the drugs for over 34 months. However, half of the patients taking D-penicillamine discontinued treatment after 18 months, due to either toxic side effects associated with the drug or ineffectiveness. The most common reason given for discontinuing methotrexate, gold salt or azathioprine therapies was ineffectiveness of the drug. Most of the side effects associated with D-penicillamine occurred within the first year of treatment while those associated with the other drugs occurred over time. More women and patients over the age of 65 stopped taking D-penicillamine than other patients taking this drug.

Usage, Methotrexate, Gold compounds, Azathioprine, Antirheumatic agents

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Respiratory chain enzyme defects in patients with idiopathic inflammatory myopathy

Article Abstract:

Disorders of the cell's energy-producing process may be involved in polymyositis. Polymyositis is chronic muscle inflammation of unknown cause. Muscle biopsies were taken from four patients with polymyositis. Staining of the compounds involved in the respiratory chain of enzymes and spectrophotometric analysis revealed abnormalities in three of these patients. In these patients, affected cell tissue also showed abnormal proliferation of mitochondria, the cell organelle containing the enzymes that process substances to provide the energy needed to fuel the cell's metabolism.

Diagnosis, Physiological aspects, Mitochondria, Polymyositis

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