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

Arthritis Rheum. 1990 Apr;33(4):477-84. doi: 10.1002/art.1780330403.


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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / pathology
  • Auranofin / administration & dosage
  • Auranofin / therapeutic use
  • Azathioprine / administration & dosage
  • Azathioprine / therapeutic use
  • Double-Blind Method
  • Drug Therapy, Combination
  • Gold Sodium Thiomalate / administration & dosage
  • Gold Sodium Thiomalate / therapeutic use
  • Humans
  • Methotrexate / administration & dosage
  • Methotrexate / therapeutic use
  • Middle Aged
  • Penicillamine / administration & dosage
  • Penicillamine / therapeutic use
  • Placebo Effect
  • Prospective Studies
  • Randomized Controlled Trials as Topic


  • Anti-Inflammatory Agents
  • Gold Sodium Thiomalate
  • Auranofin
  • Penicillamine
  • Azathioprine
  • Methotrexate