Combined disease-modifying chemotherapy for intractable rheumatoid arthritis.

When one endeavours to obtain lasting remissions in long-standing or erosive and/or highly seropositive, i.e. unrelenting, RA, combined 'aggressive' two-drug therapy appears to be reasonably well tolerated. Surprisingly, gold and D-penicillamine are not antagonistic but appear to potentiate each other to give the best results. In analogy with lymphoma and with the open trial by McCarty--and in the absence of new major 'disease-modifying' drugs--the door should be kept wide open towards controlled trials of combined three-drug chemotherapy.