[Current status of drug therapy in chronic polyarthritis]

This review covers the differential indications of oral and topical non-steroidal antiinflammatory drugs, as well as oral and intra-articular corticosteroids. The so-called "disease modifying" drugs, such as chloroquine, sulfasalazine, gold compounds and penicillamine have been surpassed by low-dose pulses of methotrexate, due to its lower short-time toxicity and higher response rate. Parenteral cyclophosphamide or corticosteroid pulses should be reserved for cases with vasculitis or refractoriness to conventional drugs. Combined treatments by several "disease modifying" drugs or immunosuppressives have not yet proved their safety or higher efficacy. Selective immunosuppressives, such as cyclosporin A, have proved to be of limited efficacy but await comparison with more established drugs. Looking to the future, cytokines, e.g. interferon gamma, and monoclonal antibodies are discussed.