Effect of drug therapy on the radiological progress of early erosive rheumatoid arthritis

Abstract EN

Objective: This work was carried out to verify the safety and the efficacy of intra-muscular gold, oral methotrexate and microdose steroid therapy in controlling articular cartilage erosions in Egyptian rheumatoid arthritis (RA) patients.

Subjects & Methods: The material of this work included the follow up recorded data of 141 RA patients (diagnosed according to ACR criteria).

All cases were selected with early erosive arthritic changes.

Forty-seven patients were treated with oral methotrexate therapy, 47 patients with intra-muscular gold and 47 patients with micordose prednisolone.

Apart from the laboratory data (ESR, SGPT, SGOT, urea, creatinine, hemoglobin), treatment outcome was assessed clinically with joint count score, duration of morning stiffness, handgrip strength, global physician and patient assessment.

Progress in joint erosion was assessed with plain X-ray examination of the hands, wrists, elbows, feet, and ankles as well as knees and cervical spine before and after the treatment period.

Results: The 3 treatment regimens proved comparable with excellent safety and efficacy.

However, microdose steroid therapy was the earliest to induce clinical remission and the MTX was the most effective in controlling joint erosions.

Concerning drug tolerability, MTX was the most tolerable one.