[Retrospective study of the effects of D-penicillamine and pyrithioxin in the treatment of rheumatoid arthritis].

The authors made a comparative study of the effectiveness and tolerance of D-penicillamine (DP) and pyrithioxine (Pyr) and investigated possible prognostic factors for the tolerance and effectiveness of these two treatments. This retrospective study concerned 150 patients with rheumatoid arthritis (RA). 86 patients were treated with DP and 64 were treated with Pyr. The percentage effectiveness, evaluated in terms of morning stiffness and the articular index as well as the need for steroidal and non-steroidal anti-inflammatory agents, attained 67.4 p. cent with DP and 51.6 p. cent with Pyr. Suspension of treatment because of ineffectiveness, was more frequent with Pyr. The changes in the following laboratory parameters were also compared: ESR, rheumatoid serology, ANF, C3 and C4 complement levels, IgG, IgA and IgM levels. The treatment was stopped definitively because of intolerance in 37.2 p. cent of cases with DP and in 29.7 p. cent of cases with Pyr. Serious renal and haematological complications are essentially, but not exclusively, due to DP.