Levamisole in rheumatoid arthritis -- a double-blind study

Levamisole was used in a double blind trial in 24 patients with severe rheumatoid arthritis (RA). Each patient received either levamisole 150 mg daily, or placebo for a period of 6 months in addition to nonsteroidal antiinflammatory therapy. Ten patients, 8 of whom were taking levamisole, failed to complete the trial. Clinically 3 or 4 patients on levamisole who completed the study showed improvement whereas 5 were considered improved on placebo. The high incidence of side effects, (rashes, gastrointestinal upset, stomatitis and depression) in the levamisole treated group indicates that this drug, in the dose used, was too toxic for the management of severe RA. A much lower incidence of side effects is reported with recent recommendations using much lower daily or even weekly dosage.