[D-penicillamine in the treatment of rheumatoid polyarthritis. 104 cases with a 5-year follow-up].

104 patients with rheumatoid arthritis were treated by D-penicillamine and were followed for 5 years after the start of treatment. At the end of the 5th year, 27 patients (26 per cent) are still taking the treatment with satisfactory results; 47 patients (45 per cent) had to stop treatment because of intolerance; 15 patients (14.5 per cent) stopped treatment because of escape or because of a poor therapeutic result and 15 patients (14.5 per cent) could not be evaluated. In the patients treated for 5 years with a satisfactory result, there was a regular decrease in the articular index which was statistically significant during the first two years of treatment. The variations in the erythrocyte sedimentation rate were less spectacular: it only decreased significantly during the first year. The variations in the serum levels of rheumatoid factor were irregular. Systemic corticosteroid therapy was able to be stopped in 6 out of 7 cases. The authors did not observe any significant correlation between the results of treatment and the age of onset of the rheumatoid arthritis, the articular index, or the initial erythrocyte sedimentation rate. In contrast, the mean history of the disease was significantly shorter in the patients with a satisfactory result at the 5th year. The majority of suspensions of treatment took place during the first 2 years of treatment and were motivated by intolerance reactions, in particular renal intolerance. Whatever the reason for the suspension of treatment, it was not influenced by the history of the rheumatoid arthritis, the rheumatoid serology, the sex of the patient or the maximal dosage of D-penicillamine.(ABSTRACT TRUNCATED AT 250 WORDS)