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Hydroxychloroquine Is Safe and Probably Useful in Rheumatoid Arthritis

Edward D. Harris, MD
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Stanford University School of Medicine, Stanford, CA 94305. Requests for Reprints: Edward D. Harris, Jr., MD, Department of Medicine, Stanford University School of Medicine, Room S-102, Stanford, CA 94305-5109.


Copyright 2004 by the American College of Physicians


Ann Intern Med. 1993;119(11):1146-1147. doi:10.7326/0003-4819-119-11-199312010-00014
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The history of antimalarial drug therapy in rheumatoid arthritis has several distinct phases. The first was a fairly widespread enthusiasm for the drugs [1]. For example, Freedman and Steinberg [2] reported a definite general improvement in 85 of 107 (80%) patients who completed 1 year of chloroquine treatment, compared with 30% of the placebo group. Whereas 25% of the control patients were clinically deteriorating, only 5% of the patients treated with chloroquine lost ground during the study. This enthusiasm was fueled by the disillusionment in the 1950s with corticosteroids as a primary therapy because of the destructive toxicity of prednisone or its equivalent used in doses greater than 10 mg/d. In addition, no satisfactory, nontoxic, nonsteroidal drugs were available as a substitute for aspirin.

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