Gold therapy in the elderly rheumatoid arthritis patient

Forty elderly (greater than or equal to 60 years old) and 101 young (less than 60 years old) rheumatoid arthritis patients receiving injectable gold therapy were followed prospectively between April 1971 and April 1982. The mean total gold compound received was 1,392 mg in the young group and 1,861 in the elderly group. Besides age, the only significant difference between the two groups was the increased gold compound received by the elderly. To determine efficacy and toxicity within and between certain age groups, the 141 patients were divided into 4 arbitrary age groups: group A (less than 30 years), group B (30-44 years), group C (45-59 years), and group D (greater than or equal to 60 years). The elderly responded to the gold therapy as well as the young patients did, at any time frame examined after 3 months of therapy. There was no difference in clinical benefit among groups A, B, C, and D. Nine patients in the elderly group and 15 in the young group had therapy discontinued because of no response. This difference was not significant among the groups A, B, C, and D. There was no difference in outcome of individual toxicity between the elderly and the young groups, and no difference in frequency of toxicity between the age groups A, B, C, and D. Serious hematologic toxicity occurred only in patients over 47 years of age, and nephrotic syndrome occurred only in patients over 52. In this study, gold therapy was found to be as clinically beneficial in the elderly as in the young patients, and the toxicity and drug failure rates were not significantly different.