Low‐Dose D‐Penicillamine Therapy in Rheumatoid Arthritis

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

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Azathioprine versus d‐penicillamine in rheumatoid arthritis patients who have been treated unsuccessfully with gold

Paulus

Williams

Ward

et al. 1984

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“…The standard joint count proposed by the Cooperative Systematic Studies of the Rheumatic Diseases program (CSSRD) includes 60 joints evaluated for tenderness (or pain on motion) and 58 joints evaluated for swelling (the hips are excluded) (5). The Ritchie Articular Index (4) includes 50 joints evaluated for tenderness (although for proximal interphalangeal [PIP] [finger], metacarpophalangeal [MCPI , and metatarsophalangeal [MTP] joints each row is counted as 1 joint).…”

mentioning

confidence: 99%

Reduced joint counts in controlled clinical trials in rheumatoid arthritis

Fuchs

Pincus

1994

101

Objective. To determine if quantitative assessment of a reduced number of joints provides information equivalent to that obtained by the traditional 60-joint evaluation in detecting changes in patients participating in clinical trials of rheumatoid arthritis (RA).Methods. The changes in quantitative joint scores of patients from 3 previously reported clinical trials were compiled and compared with changes in quantitative scores derived using a reduced number of joints. Effect sizes were calculated (mean change in joint score/ standard deviation of joint score) and compared for the different joint indices.Results. The effect sizes of the joint scores derived using a reduced number of joints were similar to those of the original 60-joint score. The reduced joint count scores revealed significant changes for clinical trials involving as few as 15 patients.Conclusion. Reduced joint count scores may be used to evaluate the results of clinical trials without decreasing the ability to detect change over time. Quantitative assessment of a reduced number of joints may also facilitate assessment of responses to treatment in the routine care of patients with RA.

“…Statistics have shown D-penicillamine (DP) and hydroxychloroquine (HCQ) to be more efficacious than placebo in relieving inflammatory disease activity, as demonstrated by articular and laboratory indices, in adult patients with rheumatoid arthritis (RA) (1,2). Despite the absence of controlled trials in children, these drugs also have been used widely in patients with juvenile rheumatoid arthritis (JRA) who have not responded adequately to treatment with nonsteroidal antiinflammatory drugs (NSAIDs).…”

mentioning

confidence: 99%

Characteristics of responders and nonresponders to slow‐acting antirheumatic drugs in juvenile rheumatoid arthritis

Giannini

Brewer

Кузьмина

et al. 1988

A 12-month double-blind, parallel, randomized, placebo-controlled multicenter trial of D-penicillamine and hydroxychloroquine was conducted in 162 children with juvenile rheumatoid arthritis in the United States and in the Union of Soviet Socialist Republics. No statistically significant intergroup differences were detected in primary outcome variables. We investigated the possible existence of select subgroups of patients who have a higher likelihood of response to active drugs than to placebo. Using previously published criteria, each patient was classified as a responder or nonresponder, and their demographic and disease characteristics at baseline were compared. We were unable to identify a subgroup of individuals who were more likely to respond to D-penicillamine or hydroxychloroquine than to placebo.