Wong C S, Champion G, Smith M D, Soden M, Wetherall M, Geddes R A, Hill W R, Ahern M J, Roberts-Thomson P J
Department of Clinical Immunology, Flinders Medical Centre, Bedford Park, South Australia.
Ann Rheum Dis. 1990 Jun;49(6):370-2. doi: 10.1136/ard.49.6.370.
To test the hypothesis that early steroid pulsing augments the efficacy and decreases the toxicity of chrysotherapy 40 patients with rheumatoid arthritis were studied in a double blind, placebo controlled study. During the first three months of gold treatment group 1 received monthly intravenous methylprednisolone pulsing (steroid group) while group 2 received placebo (placebo group). All patients were assessed clinically and serologically over a 24 week period. Twelve patients were withdrawn before completion of the study and all but one of the remaining 28 patients reported clinical and serological improvements. Two patients in the steroid group were withdrawn owing to gold induced side effects while four were withdrawn in the placebo group. These small numbers were not significantly different. Minor side effects occurred more commonly in the placebo group. The clinical response was clearly better in the steroid group with statistical significance almost being achieved. In an endeavour to obtain a significant conclusion further patients will now be entered into this study.
为验证早期使用类固醇冲击疗法可增强金疗法疗效并降低其毒性这一假设，对40例类风湿关节炎患者进行了一项双盲、安慰剂对照研究。在金治疗的前三个月，第1组每月接受静脉注射甲基强的松龙冲击治疗（类固醇组），而第2组接受安慰剂（安慰剂组）。在24周的时间里对所有患者进行了临床和血清学评估。12例患者在研究完成前退出，其余28例患者中除1例之外均报告有临床和血清学改善。类固醇组有2例患者因金制剂引起的副作用而退出，安慰剂组有4例退出。这些少量数据无显著差异。轻微副作用在安慰剂组更常见。类固醇组的临床反应明显更好，几乎达到统计学意义。为得出有意义的结论，现在将有更多患者加入本研究。
