ON THE COURSE OF SEROPOSITIVE RHEUMATOID-ARTHRITIS DURING AND AFTER LONG-TERM GOLD THERAPY

The purpose of the present study was to get an estimate on the course of seropositive RA in 93 patients, who had been in chrysotherapy for a t least 3 years up to 13 years. The study was observational with asses sment once a year by the same physician. After one year the median num ber of swollen joints had decreased from six to two (p = 0.0001), and the median number of tender joints from five to two (p=0.0001). This i mprovement was maintained throughout the period. A decrease in median erythrocyte sedimentation rate from 34 mm/h to 15 mm/h remained signif icant for 10 years, although the ESR gradually increased throughout th e period. An increase in median hemoglobin from 7.8 mmol/l to 8.5 mmol /l lasted for 7 years. Contrastingly, the number of joints with limite d motion increased from a median score of 4 to a median score of 20 (p =0.0001). Radiographical changes progressed from a median score of 18 to a median score of 84 (p = 0.0001). Significant correlations were fo und between the ESR, joint tenderness score and limitation of motion s core at the year 1, and later progression of limitation of motion scor e, but too weak to be of predictive importance. In conclusion early sy mptomatic improvement of rheumatoid arthritis during gold treatment ca n be stable during several years, but progression in the number of joi nts with limited motion and radiographical changes continues.