Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: FRIDAY, March 15, 1991                   TAG: 9103150065
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-3   EDITION: METRO 
SOURCE: Associated Press
DATELINE: PHILADELPHIA                                LENGTH: Medium

ARTHRITIS TREATMENT CALLED INEFFECTIVE FOR LONG-TERM USE

Patients with rheumatoid arthritis who were injected weekly with gold salts suffered disabilities and pain similar to what was felt by people who weren't injected, according to a study published in today's edition of the Annals of Internal Medicine.

The researchers at the University of California in San Francisco and Kaiser-Permanente Medical Center in Oakland, Calif., studied the course of arthritis in 574 patients for five years.

Other arthritis researchers said the study overstated the case against gold salts. They said other studies have shown the treatment effective in short-term use of under a year.

Of the 574 patients, the analysis compared 142 who were treated with gold salts for at least two years to 284 patients who received other treatment, according to the study's lead author, Dr. Wallace Epstein. The results were then statistically adjusted and showed that patients given gold salts received no benefit compared to those who did not receive that drug.

"The results of this study show that we must re-examine our standard treatment of this chronic disease," Epstein said.

The use of gold salts began about 50 years ago, when researchers discovered its ability to fight tuberculosis. Scientists thought it could be used similarly to fight the infection thought to cause rheumatoid arthritis. The cause of the chronic disease is unknown.

Since then, the drug has had a "roller coaster ride" in its level of acceptance, according to the president of the American College of Rheumatology, Dr. Robert Meenan of Boston University. The drug is now generally thought beneficial for about 60 percent of arthritis patients for treatment lasting less than a year, he said.

Epstein said his study was the first to look at the long-term effects of gold salts, a drug so toxic that about one-fourth of patients have to stop using it because of side effects.

Dr. John Abruzzo, a rheumatologist familiar with the study, said it was "a decent attempt, but not the final word" on the treatment.

Abruzzo, director of Thomas Jefferson University's arthritis center, said the study adds to the controversy over gold salts.

He said the data lacked enough detail about changes patients experienced during treatment, a problem he said was inherent in studies of chronic illnesses.