HLA-DR gene frequencies in 59 Japanese children with juvenile rheumatoid arthritis (JRA) and 62 Japanese adults with rheumatoid arthritis (RA) were analyzed by oligonucleotide DNA typing. As in other studies, the frequency of DRB1*0405 in RA patients was significantly higher than in the Japanese controls. In a comparison of non-classified JRA patients with Japanese controls, no significant differences were observed in the frequency of DR types. However, when the JRA patients were classified into four clinical types, i.e., a rheumatoid factor-positive [RF(+)] polyarticular type, a rheumatoid factor-negative [RF(-)] polyarticular type, a pauciarticular type, and a systemic onset type, DRB1*0405 was found to be significantly higher in the RF(+) polyarticular JRA patients than in the controls (P < 0.05). Thus, the RF(+) polyarticular type of JRA had the same HLA association as RA. This result is consistent with the fact that both RF(+) polyarticular JRA and RA cases have a similar clinical course.

A 10-year cohort study was performed, involving all of the 118 patients treated with bucillamine in our hospital between 1988 and 1990. Evaluation was made on the basis of erythrocyte sedimentation rate, grip strength, joint score, duration of morning stiffness, and Lansbury index consisting of the above four parameters. Eleven patients were male and 107 were female, with a mean age of 53 years (range: 20-79 years) and a mean duration of illness of 8.2 years (range: 2-31 years). Lansbury index remained significantly suppressed throughout the 10-year period of treatment. Continuous treatment was possible for 10 years in 18 patients (15%: 2 men and 16 women). Stage of disease did not advance in 14 patients. Six patients met the criteria for remission. Of all patients, 50% dropped out of treatment at 2.4 years after the start of treatment and 75% at 5 years. The 100 patients who dropped out could be roughly divided into three groups. One third of them dropped out because of lack of or attenuation of response. Another third dropped out because of referral to other medical facilities or discontinuation of visits to our hospital, and the remaining third dropped out because of adverse reactions to treatment. There was no particular trend in terms of sex, age, duration of sickness, drugs used before bucillamine, or level of activity of rheumatoid arthritis. There were no significant difference in the stage and class of the disease, and other backgrounds between 10-year treatment group and dropout group.

A 10-year cohort study was performed, involving all of the 118 patients treated with bucillamine in our hospital between 1988 and 1990. Evaluation was made on the basis of erythrocyte sedimentation rate, grip strength, joint score, duration of morning stiffness, and Lansbury index consisting of the above four parameters. Eleven patients were male and 107 were female, with a mean age of 53 years (range: 20-79 years) and a mean duration of illness of 8.2 years (range: 2-31 years). Lansbury index remained significantly suppressed throughout the 10-year period of treatment. Continuous treatment was possible for 10 years in 18 patients (15%: 2 men and 16 women). Stage of disease did not advance in 14 patients. Six patients met the criteria for remission. Of all patients, 50% dropped out of treatment at 2.4 years after the start of treatment and 75% at 5 years. The 100 patients who dropped out could be roughly divided into three groups. One third of them dropped out because of lack of or attenuation of response. Another third dropped out because of referral to other medical facilities or discontinuation of visits to our hospital, and the remaining third dropped out because of adverse reactions to treatment. There was no particular trend in terms of sex, age, duration of sickness, drugs used before bucillamine, or level of activity of rheumatoid arthritis. There were no significant difference in the stage and class of the disease, and other backgrounds between 10-year treatment group and dropout group.