CYCLOPHOSPHAMIDE, GOLD AND PENICILLAMINE—DISEASE-MODIFYING DRUGS IN RHEUMATOID ARTHRITIS—TAILORED DOSAGE AND ULTIMATE SUCCESS

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Abstract
Gold appears to be the disease-modifying drug of first choice for two reasons: response and absence of long-term toxicity. Although cyclophosphamide produces results as good or better than gold, the possible long-term toxicity outweighs the clinical benefit except in the unusual case. Penicillamine appears to be an acceptable drug of second choice.