Bendix G, Bjelle A
Department of Rheumatology, Gothenburg University, Sweden.
Ann Rheum Dis. 1996 Mar;55(3):169-76. doi: 10.1136/ard.55.3.169.
To study the long term tolerance of parenteral gold and subsequent drug treatment in patients with rheumatoid arthritis, including prediction of outcome and 'survival' of sequential treatments.
A retrospective cohort study of 376 patients was made, including a detailed screening of 237 patients treated in 1989. Reasons for discontinuing treatment were analysed in life table analyses, which were used to compare patients receiving parenteral gold treatment in 1985 and 1989, and two groups of patients receiving disease modifying antirheumatic drugs after parenteral gold treatment. The causes of discontinuation were followed in sequential treatments.
The estimated probability of discontinuation of parenteral gold treatment was 29% after six months and 42%, 55%, 74%, and 92% after 1, 2, 5, and 10 years, respectively. Mucocutaneous side effects were the main cause of discontinuation of parenteral gold treatment during the first three years, while the probability of discontinuation because of inefficacy dominated after four years. Side effects also constituted the main cause of discontinuation of treatments given after parenteral gold treatment during the first three years of follow up. No significant differences were found when comparing the termination rates between the first and the second and subsequent treatments after parenteral gold treatment. The main reasons for discontinuing one treatment could not predict the cause of discontinuation of the next treatment.
Mucocutaneous side effects dominated initially, while inefficacy was the dominating cause of discontinuation of long term parenteral gold treatment. No serious side effects were registered. The cause of discontinuation of one treatment did not predict the cause of discontinuation of the following drug. Drug 'survival' was the same in both treatments after parenteral gold treatment.
研究类风湿关节炎患者对肠胃外金制剂及后续药物治疗的长期耐受性，包括对治疗结果的预测以及序贯治疗的“持续时间”。
对376例患者进行回顾性队列研究，其中对1989年接受治疗的237例患者进行了详细筛查。在生命表分析中分析了停药原因，该分析用于比较1985年和1989年接受肠胃外金制剂治疗的患者，以及两组在接受肠胃外金制剂治疗后使用改善病情抗风湿药物的患者。在序贯治疗中追踪停药原因。
肠胃外金制剂治疗停药的估计概率在6个月后为29%，1年、2年、5年和10年后分别为42%、55%、74%和92%。在最初三年中，皮肤黏膜副作用是肠胃外金制剂治疗停药的主要原因，而四年后因疗效不佳导致停药的概率占主导。在随访的前三年中，副作用也是肠胃外金制剂治疗后所给予治疗停药的主要原因。比较肠胃外金制剂治疗后的首次及第二次和后续治疗的终止率时，未发现显著差异。停止一种治疗的主要原因无法预测下一种治疗的停药原因。
最初皮肤黏膜副作用占主导，而疗效不佳是长期肠胃外金制剂治疗停药的主要原因。未记录到严重副作用。一种治疗的停药原因无法预测随后药物的停药原因。肠胃外金制剂治疗后的两种治疗中药物“持续时间”相同。
