In the study functional capacity and work capacity were investigated in a series of 405 hospital patients suffering from rheumatoid arthritis. One-third of the patients had had the disease for 5 years, one-third for 10 years and one-third for 15 years. The functional capacity index presented by Lee et al. (1973) was used. Half of the patients in the 5 and 10-year groups and one-third of those in the 15-year group had good functional capacity. One-fourth in the 5 and 10-year groups and one-third of those in the 15-year group had poor functional capacity. Sixty per cent of the 5-year group, 50 per cent of the 10-year group and 33 per cent of the 15-year group were able to work. The prognosis of functional capacity and work capacity was better for young persons than for older ones. No differences were found between the prognoses for men and women. High ESR, a positive blood rheumatoid factor and joint erosion seemed to be linked with an unfavourable prognosis of functional capacity. Light work was favoured for the prognosis of functional capacity and work capacity and extensive general education and vocational training for work capacity. The results indicate that starting vocational rehabilitation at an early stage of the disease could improve the prognosis of functional capacity and work capacity.

In a series of 100 adult patients with definite rheumatoid arthritis of at most 3 years' duration and with no previous penicillamine, gold or systemic corticosteroid treatment, 50 patients were treated with D-penicillamine and 50 with gold for one yar. The dose of penicillamine was 600 mg daily. Sodium aurothiomalate was given 50 mg weekly up to a total of 13 mg/kg and thereafter 50 mg once a month. In both treatment groups a statistically significant decrease in the number of painful and/or swollen joints, an increase in haemoglobin and a decrease in ESR, serum ceruloplasmin-, alpha1-acid glycoprotein-, IgG-, IgM- and IgA levels was observed. All the changes in these clinical and laboratory tests were of the same degree in both treatment groups. In the penicillamine group 12 out of 20 seropositive patients became seronegative and in another 5 the Waaler-Rose titre dropped clearly. In the gold group, 7 out of 16 seropositive patients became seronegative, and the Waaler-Rose titre dropped in another 5. An equal increase in the number of eroded joints in hands and toes was seen in the penicillamine and the gold group. Penicillamine was discontinued because of side effects in 13 patients (26%), and gold treatment in 15 (30%). Proteinuria and/or haematuria were the most common causes of discontinuation in the penicillamine group.

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