title: Should disease-modifying agents be used in mild rheumatoid arthritis?
abstract: A 12-month double-blind controlled study comparing hydroxychloroquine 400 mg daily with placebo in 104 patients with mild RA was conducted to see whether patients with mild rheumatoid arthritis (RA) benefit from treatment with disease-modifying agents. Mild RA was defined as synovitis limited to the hands and feet, an ESR less than 30 mm/h and C-reactive protein less than 20 mg/l, a situation where accepted clinical practice is to use a non-steroidal anti-inflammatory agent alone. By 6 months, the improvement of clinical and laboratory parameters in the hydroxychloroquine treated patients was significant compared with pretreatment levels and significantly greater than the control group. This improvement was maintained at 12 months. In addition, fewer patients withdrew through lack of efficacy, eight on hydroxychloroquine versus 18 on placebo. The implications of treating this well defined group of patients is discussed.
authors.affiliation: Staffordshire Rheumatology Centre, Stoke-on-Trent.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davis
authors.forename: P T
authors.initials: PT
authors.lastname: Dawes
authors.forename: P D
authors.initials: PD
authors.lastname: Fowler
authors.forename: S
authors.initials: S
authors.lastname: Clarke
authors.forename: J
authors.initials: J
authors.lastname: Fisher
authors.forename: M F
authors.initials: MF
authors.lastname: Shadforth
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
chemical_list: D006886:Hydroxychloroquine