Twenty-three rheumatoid arthritis patients who had previously received gold therapy were selected for second course gold. Eleven patients had developed complete remission during the first course of gold therapy. Four of these had a complete response to second course gold. Of the 10 nonresponders and 2 partial responders to first course gold, none responded to second course gold. We conclude that individuals in whom first course gold is unsuccessful respond poorly to repeated gold treatments. In addition, only 36% of the patients who initially had a complete response sustained complete remission with second course gold.