A comparison of conventional and low dose sodium aurothiomalate treatment in rheumatoid arthritis

Forty-one patients were given sodium aurothiomalate either in the conventional dose of 50 mg weekly for five months or in a small dose of 10 mg weekly for the same period. Monthly maintenance injections of 50 mg and 20 mg, respectively, were continued for a further seven months. A high incidence of toxicity and the subsequent withdrawal of 15 patients from the study prevented any analysis of results beyond five months. Statistically significant clinical improvements occurred with both treatment regimes. Although there were no significant differences between the clinical measurements of the treatment groups at any stage, a significant reduction of ESR and serum IgM occurred only with the higher dose. Side-effects were more frequent and occurred earlier with conventional treatment. However, severe toxicity, demanding withdrawal from the study, was slightly more common in the low-dose group. Thus, at least in the short term, conventional- and low-dose regimes appeared equally effective. A small dose did not lesson the hazards of toxicity.