GOLD-HORMONAL THERAPY IN RHEUMATOID ARTHRITIS

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Abstract
Patients (50) with severe rheumatoid arthritis were given a combination of gold and cortisone, hydrocortisone or corticotropin. Forty-one patients tolerated a minimum of 500 mg gold salt and were followed for at least 3 months. Seventeen per cent of the patients maintained a complete remission of their disease; an additional 39% showed major improvement. Twelve per cent showed moderate improvement, and 32% maintained little or no improvement on gold after the hormone was stopped. Results closely approximate those obtained following the use of gold alone. Incidence of gold reactions was 46%. In 34% gold was discontinued because of toxicity. Hormone therapy does not lessen the need for the usual precautions when gold salts are used. Combined therapy offers a practical means of treating the severe active rheumatoid arthritic. Cortisone, hydrocortisone or corticotropin can be used to suppress the disease for several weeks to months while the gold depot is being built up. The hormone can then be discontinued with the expectation of obtaining the same therapeutic result as if gold alone were given.