Treatment of rheumatoid arthritis: our experience

Although an incredible amount of time, work and money has been spent in the evaluation of the relative efficacy of anti-rheumatic drugs, no specific resolutive therapy is currently available for rheumatoid arthritis. In these authors' experience early rheumatoid arthritis should be treated with the most powerful non-steroidal anti-inflammatory drug (indomethacin) and the most tolerated disease modifying anti-rheumatic drug (hydroxychloroquine) available. With respect to hydroxychloroquine, auranofin has a comparable efficacy, but the incidence of side effects is significantly higher than with hydroxychloroquine. Sulphasalazine provides very good results. The enthusiasm for this drug is moderated only by the high frequency of patient drop outs. Corticosteroids should be only used in patients with active disease who do not respond to conventional therapy, and/or those with life-threatening complications (i.e., vasculitis).