Pharmacy World and Science

, Volume 15, Issue 5, pp 203–207 | Cite as

A prospective analysis of risk factors for the discontinuation of second-line antirheumatic drugs

  • Math J. Wijnands
  • Martin A. Van 't Hof
  • Miek A. Van Leeuwen
  • Martin H. Van Rijswijk
  • Levinus B. A. Van de Putte
  • Piet L. C. M. Van Riel


Clinical and laboratory factors influencing the discontinuation of second-line antirheumatic drugs were prospectively studied using survival analysis in a consecutive series of 245 patients with recently diagnosed rheumatoid arthritis. A statistically significant influence of age, sex, serum IgA and HLA-DR3 on the discontinuation rate of chrysotherapy because of toxicity was observed. The discontinuation of sulfasalazine was increased by advanced age and high rank order of prescription. With respect to efficacy, high initial disease activity appeared to predispose to treatment termination of hydroxychloroquine, sulfasalazine and penicillamine. Furthermore, an influence of the rank order of prescription on discontinuation of sulfasalazine therapy because of lack of efficacy was found. Of interest is that discontinuation of hydroxychloroquine therapy because of lack of efficacy occurred less frequently in HLA-DR3-positive than in HLA-DR3-negative patients. Although these prognostic factors are of secondary importance in clinical practice, they may be of significance in the interpretation and comparison of clinical trials.


Arthritis, rheumatoid Aurothioglucose Efficacy Hydroxychloroquine Penicillamine Prognostic factors Side effects Sulfasalazine Survival analysis 


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Copyright information

© Periodicals Service Company 1993

Authors and Affiliations

  • Math J. Wijnands
    • 1
  • Martin A. Van 't Hof
    • 2
  • Miek A. Van Leeuwen
    • 3
  • Martin H. Van Rijswijk
    • 3
  • Levinus B. A. Van de Putte
    • 1
  • Piet L. C. M. Van Riel
    • 1
  1. 1.Department of RheumatologyUniversity Hospital NijmegenHB Nijmegenthe Netherlands
  2. 2.Department of Medical StatisticsUniversity Hospital Nijmegenthe Netherlands
  3. 3.Department of RheumatologyUniversity Hospital GroningenRB Groningenthe Netherlands

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