Treatment complications of rheumatoid arthritis with gold, hydroxychloroquine, D-penicillamine, and levamisole

Abstract

One hundred and twenty-five patients with active rheumatoid arthritis unresponsive to nonsteroidal antiinflammatory drugs were treated at the same center with 156 courses of either hydroxychloroquine (43), gold (29), D-penicillamine (40), or levamisole (44). Life table analysis was used to compare the risks of developing various side effects with treatment termination being the endpoint instead of death. Patients treated with levamisole had the highest risk of developing a complication (67%) and antimalarials the lowest (30%). In terms of long term acceptability, hydroxychloroquine showed fewer complications, gold and D-penicillamine were similar with rash and proteinuria being the main difficulties; however, levamisole caused the most frequent terminations mainly due to rash and leukopenia.