Vol.21 No.3

Original Article

A multicentre trial of bucillamine in the treatment of early rheumatoid arthritis (SNOW study)

Authors

Akira Sagawa1 , Atsushi Fujisaku2 , Katsunori Ohnishi3 , Masaya Mukai4 , Izumi Yasuda5 , Yoshiharu Amasaki6 , Masato Shimizu7 , Kenji Ichikawa8 , Hirofumi Ohsaki9

  • Sagawa Akira Rheumatology Clinic, Sapporo Excellent Building 5F, North-1, West-7, Chuo-ku, Sapporo 060-0001, Japan
  • Tomakomai City Hospital, 1-5-20 Shimizu-cho, Tomakomai 053-8567, Japan
  • Ohnishi Clinic Internal Medicine and Rheumatology, 5-4-6 Atsubetsuchuo-2, Atsubetsu-ku, Sapporo 004-0052, Japan
  • Sapporo City General Hospital, North-11, West-13-1-1, Chuo-ku, Sapporo 060-8604, Japan
  • Yamanotedori Yagi Hospital, 5-1-35 Nishino-3, Nishi-ku, Sapporo 063-0033, Japan
  • KKR Sapporo Medical Center, 6-3-40 Hiragishi-1, Toyohira-ku, Sapporo 062-0931, Japan
  • Hokkaido Medical Center for Rheumatic Diseases, 3-1-45 Kotoni-1, Nishi-ku, Sapporo 063-0811, Japan
  • Hokkaido Medical Center, 7-1-1 Yamanote-5, Nishi-ku, Sapporo 063-0005, Japan
  • Ohsaki Clinic, 9-6-21 Shinkotoni-7, Kita-ku, Sapporo 001-0907, Japan
Received:

14 June 2010

Accepted:

1 November 2010

Published online:

29 December 2010

Full Text

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Abstract

In this study, we enrolled early rheumatoid arthritis (RA) patients at multiple institutes who fulfilled the American Rheumatism Association 1987 revised criteria for the classification of RA, and followed the clinical results of disease-modifying anti-rheumatic drug (DMARD) treatment prospectively. With the aim of developing therapeutic guidelines using the disease activity score 28 (DAS28) as disease indices, we investigated the usefulness of bucillamine (BUC), one of the most widely used DMARDs in Japan. Eighty-one patients with early RA who had not previously been treated with DMARDs were suitable for BUC therapy as first-choice treatment. After 24 months of treatment, at least moderate improvement was seen in 87.5% of patients using the DAS28 erythrocyte sedimentation rate (ESR). After 24 months of BUC therapy, 7 patients (43.8%) met the remission criterion of DAS28 (ESR) <2.6. The 24-month BUC continuation rate was 60.5% (49/81, monotherapy + combination therapy), of which 59.2% (29/49) were on BUC monotherapy. From the efficacy and safety viewpoints alike, BUC was useful as first-choice treatment for early RA.

Key words

Bucillamine - DAS28 - Disease-modifying anti-rheumatic drugs - Early rheumatoid arthritis