[Therapy of inflammatory-rheumatic diseases with levamisol, an immunity modulating substance]

Since cellular and humoral immune mechanisms were shown to be involved in the pathogenesis of rheumatic diseases, efforts have been made to influence these systems therapeutically. Aside from suppression of the immune response, studies have been conducted to evaluate to what extent immunostimulation might be of value in the treatment of rheumatic diseases. Levamisole, chemically a simple synthetic agent recently shown to have immunorestorative capacities in anergic cancer patients, has been administered in several rheumatic diseases. The drug was administered either continuously or intermittently in a daily dose of 150 mg over several months. In about half of the rheumatoid arthritis patients a significant improvement was noted. Beneficial effects and sometimes even dramatic improvement lere observed in some patients with systemic lupus erythematosus, ankylosing spondylitis and Reiter's syndrome. Levamisole did not alter the course of psoriatic arthritis. Significant adverse reactions were leukopenia and allergic skin reactions. Other side effects were mild and did not require interruption of drug intake. The use of levamisole in rheumatic diseases is still experimental, but with accumulating experience it may provide a true improvement in control of rheumatic diseases.