Combination therapy in rheumatoid arthritis--no benefit of addition of hydroxychloroquine to patients with a suboptimal response to intramuscular gold therapy

J Rheumatol. 1993 Apr;20(4):645-9.


Objective: To determine if there is any advantage in adding hydroxychloroquine to intramuscular gold therapy in patients with rheumatoid arthritis (RA) with a suboptimal response to gold after 6 months of treatment.

Methods: Prospective double blind placebo controlled study at the Centre for Rheumatic Diseases, Glasgow Royal Infirmary and Gartnavel General Hospital, Glasgow. Patients--440 patients with RA began intramuscular gold therapy. One hundred forty-two patients with a suboptimal response at 6 months were randomized to receive additional treatment with hydroxychloroquine (400 mg/day) or placebo, and followed for a further 6 months. Outcome measures were erythrocyte sedimentation rate, C-reactive protein, Ritchie articular index, grip strength, visual analog pain score, duration of morning stiffness, health assessment questionnaire, and rate of side effects.

Results: There was no difference in outcome in terms of efficacy or toxicity.

Conclusion: There is no justification for using a combination of intramuscular gold and hydroxychloroquine in patients with RA with a partial response to gold.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / drug therapy*
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Double-Blind Method
  • Drug Therapy, Combination
  • Gold / therapeutic use*
  • Humans
  • Hydroxychloroquine / therapeutic use*
  • Injections, Intramuscular
  • Middle Aged


  • Hydroxychloroquine
  • Gold
  • C-Reactive Protein