Longterm evaluation of intermittent levamisole treatment in rheumatoid arthritis

Twenty-one patients with rheumatoid arthritis were treated discontinuously with levamisole overa prolonged period (150 mg/day, four days per week). Disease activity was completely suppressed or markedly improved in 18 patients, while three patients showed no improvement. Overall, a statistically significant improvement was recorded after six months in morning stiffness, Ritchie index, grip strength, and sedimentation rate. After 12 months treatment, the morning stiffness, Ritchie index, grip strength, and sedimentation rate were still significantly improved. After 18 months treatment, only the morning stiffness was still improved as compared to the initial evaluation. Improvement in the other indices was no longer significant. The beneficial effect of levamisole therapy occurred slowly, reaching a maximum after six months. Similar improvement was observed in patients with advanced disease as in the early stages. Intermittent levamisole administration would appear to be as effective as continuous treatment. While minor side effects occurred just as frequently as with continuous administration, the discontinuous treatment used in this study was free of serious side reactions.