Cyclophosphamide, Gold and Penicillamine—disease-Modifying Drugs in Rheumatoid Arthritis—tailored Dosage and Ultimate Success

Gold appears to be the disease-modifying drug of first choice for two reasons: response and absence of long-term toxicity. Although cyclophosphamide produces results as good or better than gold, the possible long-term toxicity outweighs the clinical benefit except in the unusual case. Penicillamine appears to be an acceptable drug of second choice.