[Analysis of cases showing adverse reactions toward many kinds of DMARDs]

There are only six DMARDs (disease modifying anti-rheumatic drugs) available in the clinical practice, such as gold sodium thiomalate, D-penicillamine, bucillamine, auranofin, salazosulphapyridine, and lobenzarit disodium. It is important to select an appropriate DMARD for the patient. However, 57 of the 171 patients showed an adverse reaction toward one DMARD and 26 (46%) of these 57 patients showed undesirable reactions to other DMARDs. In this paper we emphasized (1) that this rate 46% of adverse reaction against multiple DMARDs was elevated and (2) that the rate of frequency of adverse reactions against two drugs was elevated. The ranking orders of the frequency of the adverse reactions of the switching of one DMARD to another are as follows; 1. gold sodium thiomalate to D-penicillamine, 2. gold sodium thiomalate to bucillamine, 3. D-penicillamine to bucillamine. Therefore, a special attention for switching DMARDs should be paid to the patient who has already shown an adverse reaction to one DMARD, and we should lower the dose of DMARDs administered to the patient. In addition, steroid was found not to decrease the rates of the adverse reaction against DMARDs.