CHANGING PATTERNS IN THE USE OF SLOW-ACTING ANTIRHEUMATIC DRUGS FOR THE TREATMENT OF RHEUMATOID-ARTHRITIS

Aim. To report on the changing use of slow acting antirheumatic drugs in the treatment of rheumatoid arthritis by contrasting prescribing pa tterns in 1990 and 1995. Method. Data were extracted from the case not es of 103 outpatients with rheumatoid arthritis. Results were compared with those obtained in 1990 in a survey of 81 patients using identica l methods. Results. There was a significant increase in the use of met hotrexate between 1990 and 1995, and a marked decrease in the use of a uranofin. A new feature was the use of drugs in combination. Methotrex ate was the most effective agent and auranofin least effective (p = 0. 02). The agent with the highest average toxicity score was D-penicilla mine. The long term tolerability of methotrexate was superior, with a median time for remaining on therapy 6.4 times longer than that of the other slow acting antirheumatic drugs (p=0.01). Conclusions. Our resu lts suggest that identified trends in the altered use of slow acting a ntirheumatic drugs for treatment of rheumatoid arthritis are rationall y based on the increased use of the most effective agents and decrease d use of those with greater toxicity and lesser efficacy.