Steven M M, Hunter J A, Murdoch R M, Capell H A
Br Med J (Clin Res Ed). 1982 Jan 9;284(6309):79-81. doi: 10.1136/bmj.284.6309.79.
In a prospective study 88 patients, with rheumatoid arthritis who had stopped taking gold, penicillamine, or levamisole were randomly allocated to one of the alternative drugs and followed up for a minimum of one year. Concurrent studies of the effects of gold, penicillamine, and levamisole prescribed in 123 patients as the first second-line drug were used for comparison. No difference in toxicity or efficacy between primary and secondary use of gold or penicillamine was identified. Variation in the toxicity of levamisole could in part be accounted for by changes in the dose regimen over the four years of study. The length of the treatment-free interval between drugs did not influence subsequent development of toxicity. These results suggest that an adverse reaction to one of the three second-line drugs studied should not prejudice the selection of another.
在一项前瞻性研究中，88名已停用金制剂、青霉胺或左旋咪唑的类风湿性关节炎患者被随机分配至其中一种替代药物，并进行了至少一年的随访。同时，对123名将金制剂、青霉胺和左旋咪唑作为一线二线药物使用的患者进行了研究以作比较。未发现金制剂或青霉胺一线和二线使用时在毒性或疗效上存在差异。左旋咪唑毒性的变化部分可归因于研究四年间给药方案的改变。药物之间无治疗间隔期的长短并不影响后续毒性的发生。这些结果表明，对所研究的三种二线药物之一出现的不良反应不应影响对另一种药物的选择。
