ANALYSIS OF IMPROVEMENT IN INDIVIDUAL RHEUMATOID-ARTHRITIS PATIENTS TREATED WITH DISEASE-MODIFYING ANTIRHEUMATIC DRUGS, BASED ON THE FINDINGS IN PATIENTS TREATED WITH PLACEBO

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 ⩾20% for morning stiffness, Westergren erythrocyte sedimentation rate, joint pain/tenderness score, and joint swelling score, and by ⩾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. Copyright © 1990 American College of Rheumatology