Placebo controlled trials of DMARD treatment for early RA
| Author (reference) | Study design | Mean disease duration (months) | Treatment | Outcome | Evidence category |
|---|---|---|---|---|---|
| DMARD, disease modifying antirheumatic drug; EMS, early morning stiffness; GS, grip strength; HAQ, Health Assessment Questionnaire; PGA, patient global assessment of disease activity; RF, rheumatoid factor; RI, Ritchie Index. | |||||
| *Mild RA defined as disease affecting hands and feet only, CRP <20 mg/l, ESR <30 mm/1st h. All patients satisfied either the 1987 revised ACR diagnostic criteria, or the pre-1987 ARA diagnostic criteria. | |||||
| Adapted from Quinn, Conaghan, and Emery. The therapeutic approach of early intervention for rheumatoid arthritis (submitted). | |||||
| Australian Multicentre Clinical Trial Group68 | Randomised, placebo controlled trial; 105 non-erosive, DMARD-naive patients; 6 month study | <12 | Sulfasalazine | Significantly reduced swollen and tender joints, ESR/CRP, RF, RI, and EMS | Ib |
| Borg et al69 | Double blind, randomised, placebo controlled trial; 138 DMARD naive patients; 12 month study | 11 | Oral gold | Significantly reduced swollen joint counts, x ray progression, and HAQ functional score | Ib |
| Davis et al70 | Double blind, randomised, placebo controlled trial; 104 mild RA*, DMARD naive patients; 12 month study | 14 | Hydroxychloroquine | Significantly reduced RI synovial score, ESR, EMS, and improved GS | Ib |
| Hannonen71 | Double blind, randomised, placebo controlled trial; 80 DMARD naive patients; 12 month study | 5 | Sulfasalazine | Significantly reduced swollen joint counts, RI, PGA, pain, and improved GS | Ib |
| HERA72 | Double blind, randomised, placebo controlled trial; 120 DMARD naive patients; 8 month study | 9 | Hydroxychloroquine | Reduced swollen and tender joint counts, HAQ, EMS, pain, and improved GS | Ib |