RADIOGRAPHIC ASSESSMENT OF DISEASE PROGRESSION IN RHEUMATOID-ARTHRITIS PATIENTS ENROLLED IN THE COOPERATIVE SYSTEMATIC STUDIES OF THE RHEUMATIC DISEASES PROGRAM RANDOMIZED CLINICAL-TRIAL OF METHOTREXATE, AURANOFIN, OR A COMBINATION OF THE 2
A. Lopezmendez et al., RADIOGRAPHIC ASSESSMENT OF DISEASE PROGRESSION IN RHEUMATOID-ARTHRITIS PATIENTS ENROLLED IN THE COOPERATIVE SYSTEMATIC STUDIES OF THE RHEUMATIC DISEASES PROGRAM RANDOMIZED CLINICAL-TRIAL OF METHOTREXATE, AURANOFIN, OR A COMBINATION OF THE 2, Arthritis and rheumatism, 36(10), 1993, pp. 1364-1369
Objective. To determine the radiographic progression of disease in rhe
umatoid arthritis (RA) patients from the Cooperative Systematic Studie
s of the Rheumatic Diseases clinical trial of auranofin (AUR) versus m
ethotrexate (MTX) versus a combination of the two. Methods. Baseline (
week-0) and study-end (week-48) hand/wrist radiographs in 200 of the 2
11 patients who completed this multicenter trial (95%) were scored bli
ndly by 2 readers for the presence of erosions and joint space narrowi
ng (JSN). Both intraobserver reliability and interobserver reliability
were 0.80 for erosions (P less-than-or-equal-to 0.001); intraobserver
reliability and interobserver reliability were both 0.75 for JSN (P l
ess-than-or-equal-to 0.001). Results. Worsening erosion and JSN scores
occurred in all 3 treatment groups, but the difference from baseline
reached significance only in the AUR group. Conclusion. Clinical impro
vement has been clearly documented in all 3 treatment groups in this t
rial. Radiographic deterioration occurs in RA even when clinical featu
res improve, but progression of disease as determined radiographically
may be slowed by treatment with MTX.