Disease-modifying drugs for progressive rheumatoid arthritis.

In patients with rheumatoid arthritis who do not respond to therapy with salicylates or nonsteroidal anti-inflammatory agents, stronger and potentially more toxic drugs are then considered. At the present time in the United States, this generally means a trial of hydroxychloroquine, gold, penicillamine, azathioprine, or cyclophosphamide. Each of these drugs is discussed with regard to pharmacology and possible modes of action, pertinent clinical studies, and toxicity.