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polymyositis, which can be a devastating disease involving the
muscles, you have to use, really immediately, large doses of corti-
costeroids. I do not know of anything else right now I would take a
chance on using. The main point that I brought up, which is in the
statement I have submitted, is that I think it might have, as I
mentioned before, a role in acute injuries, where its analgesic
effects can be more readily used.
I think really what I am expressing again is very much the
statement that was made from that Ad Hoc Committee. We looked
very hard at over 1,000 references and could not find proof of the
efficacy of this drug.
Now, I am a member of a group for U.S.-U.S.S.R. studies in
rheumatology. I have made trips there and been at the Rheuma-
tism Research Institute in Moscow, which is their chief research
institute, as well as the one in Vilnius. And frankly, although they
have it in their formulary but going through the wards and seeing
the patients; I had never seen DMSO used by the Russians.
I have visited and lectured at many major universities in Japan.
Again, I investigated the wards to see the patients and it is not
used widely there. I do not know why, because the drug is available
for use in those countries but yet the rheumatologists there do not
seem to use it.
I think that is all I have to say at this point. It is getting late.
[See app. 10, p. 137, letter from Dr. Baum.]
PREPARED STATEMENT BY JOHN BAUM, M.D.
My knowledge of this drug is from my work as a member of the National
Research Council-National Academy of Science Committee that studied DMSO. I
worked on this panel from 1972 to 1974. As a member of this council I reviewed
hundreds of physician's statements on the use of this drug and in addition reviewed
with the panel over 1000 publications on its use. I have also had personal experience
using this drug in the treatment of osteoarthritis, bursitis and acute soft tissue
injuries.
Dimethyl sulfoxide (DMSO) is an interesting drug, which has still to find its
proper place in the medical armamentarium. Although there are over 1,000 refer-
ences in the world literature to the various facets of this drug's pharmacology,
structure, and use, it is difficult for us to pluck out of this morass a well-defined
picture of how it can be used.
There are some glimmerings in the field of rheumatological disease. This material
can probably be utilized as a definitely helpful adjunct therapy in some areas of the
field.
At the present time there is no clear-cut evidence that DMSO has any effect on
any of the basic disease processes of the connective tissue diseases. The possible role
of DMSO in a few fields will be discussed.
Only a limited number of studies have been performed in which DMSO has been
used as a form of therapy for osteoarthritis. In this condition, in which pain is a
prominent feature and analgesics are required, DMSO might play a role because of
its local analgesic properties.
It may also be useful in the treatment of rheumatoid arthritis. Though no good
studies have been made to prove this, the idea is based on a study performed by a
group of Japanese rheumatologists who used DMSO in the treatment of patients
with rheumatoid arthritis. Although their methods present problems, in general
this was well done; the major effect of DMSO appeared to be relief of pain, with no
apparent effect on the inflammatory processes. Treatment of rheumatoid arthritis
requires drugs that are both analgesic and anti-inflammatory. (Parenthetically, in
osteoarthritis, where there is little or no inflammation, the analgesic properties of
DMSO would probably play a greater role.) We do have pure systemic analgesic
drugs such as codeine and acetaminophen, but occasionally these all produce side
effects that necessitate their abandonment in therapy.
One of the most controversial subjects in discussion of the use of DMSO is the
treatment of scleroderma. On the basis of what has been published in the world
literature, it is hard to come to a firm conclusion on the role of DMSO in this
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