Does second-line therapy affect the radiological progression of rheumatoid arthritis?

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Abstract
The effect of 2nd-line drugs on radiological progression in rheumatoid arthritis is not clear, and previous studies have yielded contradictory results. Patients (67) with rheumatoid arthritis were followed up clinically and radiologically for .apprx. 2 yr (26 patients were receiving i.m. gold, 21 penicillamine, 10 levamisole, and there were 10 controls who had consistently refused 2nd-line therapy). Patients on gold and penicillamine showed improvement in erythrocyte sedimentation rate and Hb over 2 yr which was not seen in levamisole and control patients, but hand radiograph scores in all 4 groups showed statistically significant deterioration. There was a trend towards slowing of the rate of erosion in the gold and penicillamine groups in comparison with controls, but healing of erosions was extremely unusual.