Clinical Rheumatology

, Volume 7, Issue 2, pp 242–248 | Cite as

Sulphasalazine in rheumatoid arthritis: Combination therapy with D-penicillamine or sodium aurothiomalate

  • M. Farr
  • G. Kitas
  • P. A. Bacon


This open study examined the safety of adding a second slow-acting antirheumatic drug (SARD) — D-penicillamine or sodium aurothiomalate — to the therapy of 38 rheumatoid patients already established on sulphasalazine. Combined anti-rheumatic therapy given in this way was generally well-tolerated and the incidence of adverse reactions was not increased. During the first year none of the reactions were serious although 9 of the 29 patients (31%) given D-penicillamine and 3 of the 9 patients receiving aurothiomalate developed side-effects requiring withdrawal of the second SARD. Reactions attributed to D-penicillamine were: gastro-intestinal-6, rashes-2, and blurring of vision-1. All 3 reactions occurring with gold were rashes, 2 associated with proteinuria and one with increased liver enzymes. During the second year D-penicillamine was withdrawn in 4 patients due to thrombocytopenia-2, and rashes-2. In addition an overall favourable clinical response was achieved in 70% of patients. This approach for combination therapy whereby a second SARD is given to patients already established on a single SARD, appears to minimise the toxicity which is a problem when 2 SARDs are started simultaneously.

Key words

Sulphasalazine Rheumatoid Arthritis Combination Therapy 


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Copyright information

© Acta Medica Belgica 1988

Authors and Affiliations

  • M. Farr
    • 1
  • G. Kitas
    • 1
  • P. A. Bacon
    • 1
  1. 1.Department of RheumatologyUniversity of BirminghamBirminghamUK

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