CLINICAL TRIAL OF THE THERAPEUTIC VALUE OF CERTAIN ANTIRHEUMATIC DRUGS

Journal/Book: Anu. rheum. Dis. (1960) 19 251-256. 1960;

Abstract: Consultatiebureaus voor Rheumatische Ziekten of the Rotterdams Stichting voor Rheumabestrijding Rotterdam Netherlands Summary In a "double-blind" trial of drugs in the treatment of rheumatoid arthritis 191 patients with definite rheumatoid arthritis (American Rheumatism Association criteria) were given in four successive courses of 6 weeks: three daily doses of 1 g. aspirin three daily doses of 0-5 g. aminopyrin three daily doses of 200 mg. phenylbutazone and three daily doses of a placebo. All the powders looked the same and had the same taste. The Order in which the drugs and the placebo were taken by the patient was determined by Chance. Between each period of 6 weeks there was an interval of 2 weeks. All the patients were examined at the beginning and end of each period by one of the authors and the improvement or deterioration was noted according to the following criteria: (1) Hand grip (mm. Hg); (2) Tenderness an pressure (metacarpophalangeal joints); (3) Erythrocyte sedimentation rate (Westergren); (4) Subjective judgment of the therapeutic result. The results of this trial suggest that in the dosages used phenylbutazone is the best analgesic drug in rheumatoid arthritis followed by aminopyrin and aspirin in that Order and the authors desire to Limit their conclusions to this statement. Toxic reactions were least with the placebo and increased with aspirin aminopyrin and phenylbutazone in that order but the differences are not large enough to be significant in this series of patients. The authors acknowledge with gratitude the co-operation of Dr. E. F. Drion and Mr. Th. J. D. Erlee of the Statistical Department of Toegepost Natuurkundig Onderzoek The Hague who did all the statistical work essential for this study and gave much valuable criticism and advice. schö

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