Analysis of improvement in individual rheumatoid arthritis patients treated with disease-modifying antirheumatic drugs, based on the findings in patients treated with placebo. The Cooperative Systematic Studies of Rheumatic Diseases Group.
A composite index for estimating improvement in individual rheumatoid arthritis (RA) patients during trials of slow-acting, disease-modifying antirheumatic drugs (DMARDs) was developed by analyzing the responses of 130 placebo-treated participants in Cooperative Systematic Studies of Rheumatic Diseases studies. If responses in 4 of 6 selected measures were required for improvement (by greater than or equal to 20% for morning stiffness, Westergren erythrocyte sedimentation rate, joint pain/tenderness score, and joint swelling score, and by greater than or equal to 2 grades on a 5-grade scale, or from grade 2 to grade 1 for patient's and physician's overall assessments of current disease severity), few placebo-treated patients qualified as improved, whereas significantly more DMARD-treated patients demonstrated improvement. The proposed index appears to be useful in estimating the probability that an RA patient will improve if taking a placebo during a DMARD trial, and may be a useful tool for analysis of DMARD studies.
Paulus
H E
HE
Division of Rheumatology, University of California, Los Angeles School of Medicine 90024-1670.
Egger
M J
MJ
Ward
J R
JR
Williams
H J
HJ
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology; D001310:Auranofin / Q000008:administration & dosage / Q000627:therapeutic use; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006052:Gold Sodium Thiomalate / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D010396:Penicillamine / Q000008:administration & dosage / Q000627:therapeutic use; D015990:Placebo Effect; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic
D000893:Anti-Inflammatory Agents; D006052:Gold Sodium Thiomalate; D001310:Auranofin; D010396:Penicillamine; D001379:Azathioprine; D008727:Methotrexate