Immunotherapy with levamisole in rheumatic diseases

The immuno-modulatory effect of Levamisole in the treatment of rheumatic diseases was studied in an open trial. Nine patients with theumatoid arthritis (RA), 13 with ankylosing spondylitis (AS) and one with Reiter's syndrome (RS) were treated initially with 150 mg Levmisole daily for 4 weeks, then intermittently 3 days a week. Significant clinical improvement was observed in 7 out of 9 patients with RA, in 4 out of 13 patients with AS, and in the one patient with RS. An increased skin sensitivity to a panel of antigens was noted in 3 out of 9 RA patients and in 6 out of 13 AS patients. A fall in rheumatoid factor titre was observed in 2 out of 5 patients with seropositive RA. No development of other auto-antibodies was observed. No significant changes in the absolute lymphocyte counts either of the total counts or of the T, B, and null cell counts, were noted. Drug-related adverse reactions were seen in 13 patients, mostly allergic skin rash which required a short interruption in therapy. Severe leucopenia was observed in 2 patients, whereupon therapy was definitely withdrawn. Levamisole seems to have a definite beneficial effect on RA and a possible effect on AS and RS. Severe adverse reactions, mostly on the haemopoietic system, demonstrated some potential hazardous complications of the drug and required physical and laboratory examinations at short intervals.