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To the rheumatologist, the term "second-line agent" refers to a class of drugs used in treatment of rheumatoid arthritis when aspirin and nonsteroidal anti-inflammatory drugs (first-line) have failed. Second-line agents include gold, hydroxychloroquine, D-penicillamine, azulfidine, azathioprine, and methotrexate. Cyclosporine is still experimental, and studies with FK506 are just being initiated. With regard to systemic lupus erythmatosus and vasculitis, a "second agent," usually an immunosuppressant, is often required when corticosteroids alone are inadequate.
How can yet another discussion of these drugs justify more than 600 pages of text at a cost of $165.00? The answer is simple: there is no way.
Second-Line Agents in the Treatment of Rheumatic Diseases. Ann Intern Med. 1992;117:542. doi: https://doi.org/10.7326/0003-4819-117-6-542_4
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Published: Ann Intern Med. 1992;117(6):542.
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