Bianucci G, Maddali Bongi S, Cencetti A, Curradi C
Istituto di Clinica Medica Generale e Cardiologia, Università degli Studi di Firenze.
Clin Ter. 1996 Dec;147(12):609-20.
We studied 20 patients suffering from rheumatoid arthritis treated with small doses of sodium aurothiomalate (20 mg/month, seldom 40 mg/month) for a mean time of 6.1 years (range 2.7-10.6). 16 subjects were women and 4 men; their mean age was 58 years (range 35-77). 9 patients (45%) were affected by seropositive RA; the mean duration of disease was 1.5 years (range 0.3-7.3). 14 patients achieved the grade 1 of disease activity, evaluated by Mallya and Mace's (1981) criteria: 9 subjects after 3-9 months and 5 subjects after 2-5 years. The mean length of this remission state was 4.3 years (range 0.9-9.9). Side dermatological effects (skin rashes, pruritus, exfoliative dermatitis) were observed in 3 patients (15%); 1 patient (5%) was withdrawn from the study. We have discussed the numerous advantages of low doses of sodium aurothiomalate monotherapy, although this therapy has to be employed only in patients selected by prognostic features. Moreover we briefly mention the actual opinions in R.A. therapy that discuss the traditional pyramidal approach in favour of more aggressive therapy with combination of various disease-modifying drugs in many R.A. patients.
我们研究了20例类风湿性关节炎患者，这些患者接受小剂量金硫葡糖（每月20毫克，很少为每月40毫克）治疗，平均治疗时间为6.1年（范围2.7 - 10.6年）。16名受试者为女性，4名受试者为男性；他们的平均年龄为58岁（范围35 - 77岁）。9例患者（45%）为血清阳性类风湿关节炎；疾病平均持续时间为1.5年（范围0.3 - 7.3年）。根据Mallya和Mace（1981年）的标准评估，14例患者达到疾病活动1级：9例患者在3 - 9个月后达到，5例患者在2 - 5年后达到。这种缓解状态的平均时长为4.3年（范围0.9 - 9.9年）。3例患者（15%）出现皮肤副作用（皮疹、瘙痒、剥脱性皮炎）；1例患者（5%）退出研究。我们讨论了小剂量金硫葡糖单一疗法的诸多优点，尽管这种疗法仅适用于根据预后特征挑选出的患者。此外，我们简要提及了类风湿关节炎治疗中的当前观点，这些观点讨论了传统的阶梯式治疗方法，主张在许多类风湿关节炎患者中采用更积极的联合多种改善病情药物的治疗方法。
