[Combined drug therapy in recent-onset rheumatoid arthritis. Evaluation after 1 year of treatment].

The aim of our study is to evaluate the efficacy and safety of a combination therapy with hydroxycloroquine, gold sodium thiomalate and methotrexate in patients affected by recent onset active rheumatoid arthritis. Twenty-five patients (6 men e 19 women, average age 46.2 +/- 12.2) were enrolled in this study and 18 of them have been treated for 1 year with the three above-mentioned drugs at optimal doses. Drug toxicity was carefully monitored. Clinical and hematochemical parameters of efficacy were evaluated every three months. Radiographic joint study was performed at the beginning and at the end of the study. Seven patients dropped out, six of them for side effects, due to hydroxycloroquine in 1 case and to gold sodium thiomalate in 5 cases; 1 patient withdrew his consent. No life-threatening or irreversible adverse reactions were observed. The eighteen patients who completed the one year trial presented a remarkable improvement of clinical and hematochemical parameters. In only 1 case one erosion appeared at the end of the study. In conclusion, the combination therapy with hydroxycloroquine, gold sodium thiomalate and methotrexate seems to be effective and burdened by an acceptable level of toxicity.