DC-ART - DECREASED INFLAMMATORY SYNOVITIS

As part of the proposal for drug development using the SMARD/DC-ART de finitions, ''decreased inflammatory synovitis'' needs to be defined. W e review the literature with respect to each of the indirect, clinical measures of decreased inflammatory synovitis and recommend a prelimin ary, testable definition based on a per patient response. It includes minimum disease activity criteria for patients entering studies and im provement in at least 5 of the following 6 criteria: greater than 20% improvement in joint swelling count; greater than 20% improvement in j oint tenderness count; greater than 20%; improvement in erythrocyte se dimentation rate; greater than 30% improvement in physician/assessor g lobal assessment; greater than 30% improvement in pain. While this def inition is sensible within the confines of our knowledge to date, usin g these critera prospectively in several clinical trials will allow be tter definition of the appropriate pooled index to define decreased in flammatory synovitis.