Presence of HLA-DRB1 alleles in a group of patients with rheumatoid arthritis treated with low doses of sodium aurothiomalate.

The good results of a therapy with small doses of sodium aurothiomalate (20 mg/month) in 17 patients suffering from rheumatoid arthritis are reported. The mean age +/- ESM at the beginning of treatment was 59.9 +/- 3.2 years, the mean duration of disease was 1.3 +/- 0.5 years. The lowest grade of disease activity (1) according to Mallya and Mace's (1981) criteria was observed in 12 patients (70%) after a period of 1.7 +/- 0.6 years (mean +/- ESM). This grade of activity persisted in 11 patients and remained for 3 years in 1 patient. In the other 5 patients a low or middle activity of disease persisted. The relationship between therapeutic results and HLA DRB1 prevalence was investigated. The LLEQRRAA and LLEQKRAA sequences are present in 3 patients, i.e. 17.9%. This frequency is not significantly different from the frequency (28.6%) observed in a control group of healthy subjects. Therefore these sequences, at least in Italian people, cannot be considered a factor of susceptibility to RA. They may be a factor of evolution to a more severe disease. Dermatological side effects were evident only in 2 patients; one of these patients was HLA DR5 positive. The results observed in DR7 positive patients were not different from the results observed in the other patients; therefore, DR7 positive patients could responders to gold treatment, even with low doses.