Skip to main content
British Medical Journal logoLink to British Medical Journal
. 1973 Jun 23;2(5868):685–688. doi: 10.1136/bmj.2.5868.685

Method for Assessing Therapeutic Potential of Anti-inflammatory Antirheumatic Drugs in Rheumatoid Arthritis

Peter Lee, John Webb, John Anderson, W Watson Buchanan
PMCID: PMC1589743  PMID: 4582051

Abstract

A 14-day, single-blind trial of prednisone, aspirin, and placebo was carried out in 128 patients suffering from rheumatoid arthritis, using subjective criteria only (severity of pain daily on a pain chart and assessment of the drug for effectiveness). The average treated pain rating, mean patient satisfaction rating, and mean number of days withdrawn from each drug all showed significant differences between prednisone, aspirin, and placebo. Of various pretreatment observations, only the initial pain score and articular index of joint tenderness were significantly related to the average treated pain rating.

The trial method is simple and allows many patients to participate without being time consuming for patient or physician. The method seems to have potential in comparing the comparative effectiveness of anti-inflammatory analgesics used in the treatment of patients with rheumatoid arthritis.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BEECHER H. K. The measurement of pain; prototype for the quantitative study of subjective responses. Pharmacol Rev. 1957 Mar;9(1):59–209. [PubMed] [Google Scholar]
  2. BENDER A. D. PHARMACOLOGIC ASPECTS OF AGING: A SURVEY OF THE EFFECT OF INCREASING AGE ON DRUG ACTIVITY IN ADULTS. J Am Geriatr Soc. 1964 Feb;12:114–134. doi: 10.1111/j.1532-5415.1964.tb00344.x. [DOI] [PubMed] [Google Scholar]
  3. Bellville J. W., Forrest W. H., Jr, Miller E., Brown B. W., Jr Influence of age on pain relief from analgesics. A study of postoperative patients. JAMA. 1971 Sep 27;217(13):1835–1841. [PubMed] [Google Scholar]
  4. Boardman P. L., Hart F. D. Clinical measurement of the anti-inflammatory effects of salicylates in rheumatoid arthritis. Br Med J. 1967 Nov 4;4(5574):264–268. doi: 10.1136/bmj.4.5574.264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. COPEMAN W. S. C., SAVAGE O., BISHOP P. M. F., DODDS E. C., GOTTLIEB B., GLYN J. H. H., HENLY A. A., KELLIE A. E. A study of cortisone and other steroids in rheumatoid arthritis. Br Med J. 1950 Oct 14;2(4684):849–855. doi: 10.1136/bmj.2.4684.849. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chapman W. P., Jones C. M. VARIATIONS IN CUTANEOUS AND VISCERAL PAIN SENSITIVITY IN NORMAL SUBJECTS. J Clin Invest. 1944 Jan;23(1):81–91. doi: 10.1172/JCI101475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Collins A. J., Cosh J. A. Temperature and biochemical studies of joint inflammation. A preliminary investigation. Ann Rheum Dis. 1970 Jul;29(4):386–392. doi: 10.1136/ard.29.4.386. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Collins K. E., Deodhar S., Nuki G., Whaley K., Buchanan W. W., Dick W. C. Radioisotope study of small joint inflammation in rheumatoid arthritis. Ann Rheum Dis. 1971 Jul;30(4):401–405. doi: 10.1136/ard.30.4.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. DIAGNOSTIC criteria for rheumatoid arthritis: 1958 revision by a committee of the American Rheumatism Association. Ann Rheum Dis. 1959 Mar;18(1):49–53. [PMC free article] [PubMed] [Google Scholar]
  10. Dick W. C., Grayson M. F., Woodburn A., Nuki G., Buchanan W. W. Indices of inflammatory activity. Relationship between isotope studies and clinical methods. Ann Rheum Dis. 1970 Nov;29(6):643–648. doi: 10.1136/ard.29.6.643. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Dick W. C., Neufeld R. R., Prentice A. G., Woodburn A., Whaley K., Nuki G., Buchanan W. W. Measurement of joint inflammation. A radioisotopic method. Ann Rheum Dis. 1970 Mar;29(2):135–137. doi: 10.1136/ard.29.2.135. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. GRUBER C. M., Jr, BAPTISTI A., Jr Estimating the acceptability of morphine and noracymethadol in postpartum patients. Clin Pharmacol Ther. 1963 Mar-Apr;4:172–181. doi: 10.1002/cpt196342172. [DOI] [PubMed] [Google Scholar]
  13. HART F. D., CLARK C. J. M. Measurement of digital swelling in rheumatoid arthritis. Lancet. 1951 Apr 7;1(6658):775–775. doi: 10.1016/s0140-6736(51)92192-7. [DOI] [PubMed] [Google Scholar]
  14. HOLLANDER J. L., STONER E. K., BROWN E. M., Jr, DeMOOR P. Joint temperature measurement in the evaluation of anti-arthritic agents. J Clin Invest. 1951 Jul;30(7):701–706. doi: 10.1172/JCI102483. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. HOUDE R. W., WALLENSTEIN S. L., ROGERS A. Clinical pharmacology of analgesics. 1. A method of assaying analgesic effect. Clin Pharmacol Ther. 1960 Mar-Apr;1:163–174. doi: 10.1002/cpt196012163. [DOI] [PubMed] [Google Scholar]
  16. Hart F. D., Huskisson E. C. Measurement in rheumatoid arthritis. Lancet. 1972 Jan 1;1(7740):28–30. doi: 10.1016/s0140-6736(72)90015-3. [DOI] [PubMed] [Google Scholar]
  17. LANSBURY J. Report of a three-year study on the systemic and articular indexes in rheumatoid arthritis; theoretic and clinical considerations. Arthritis Rheum. 1958 Dec;1(6):505–522. doi: 10.1002/art.1780010604. [DOI] [PubMed] [Google Scholar]
  18. LASAGNA L., BEECHER H. K. The optimal dose of morphine. J Am Med Assoc. 1954 Sep 18;156(3):230–234. doi: 10.1001/jama.1954.02950030022008. [DOI] [PubMed] [Google Scholar]
  19. LASAGNA L., MOSTELLER F., VON FELSINGER J. M., BEECHER H. K. A study of the placebo response. Am J Med. 1954 Jun;16(6):770–779. doi: 10.1016/0002-9343(54)90441-6. [DOI] [PubMed] [Google Scholar]
  20. LASAGNA L. The clinical measurement of pain. Ann N Y Acad Sci. 1960 Mar 30;86:28–37. doi: 10.1111/j.1749-6632.1960.tb42788.x. [DOI] [PubMed] [Google Scholar]
  21. Mainland D. The estimation of inflammatory activity in rheumatoid arthritis. Role of composite indices. Arthritis Rheum. 1967 Feb;10(1):71–77. doi: 10.1002/art.1780100111. [DOI] [PubMed] [Google Scholar]
  22. O'Brien W. M. Indomethacin: a survey of clinical trials. Clin Pharmacol Ther. 1968 Jan-Feb;9(1):94–107. doi: 10.1002/cpt19689194. [DOI] [PubMed] [Google Scholar]
  23. Ritchie D. M., Boyle J. A., McInnes J. M., Jasani M. K., Dalakos T. G., Grieveson P., Buchanan W. W. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med. 1968 Jul;37(147):393–406. [PubMed] [Google Scholar]
  24. STEVENS S. S., GALANTER E. H. Ratio scales and category scales for a dozen perceptual continua. J Exp Psychol. 1957 Dec;54(6):377–411. doi: 10.1037/h0043680. [DOI] [PubMed] [Google Scholar]
  25. Sherman E. D., Robillard E. Sensitivity to Pain in the Aged. Can Med Assoc J. 1960 Oct 29;83(18):944–947. [PMC free article] [PubMed] [Google Scholar]
  26. WRIGHT V. Some observations on diurnal variation of grip. Clin Sci. 1959 Feb;18(1):17–23. [PubMed] [Google Scholar]
  27. Weiss T. E., Maxfield W. S., Murison P. J., Hidalgo J. U. Scintillation scanning in rheumatoid arthritis. South Med J. 1966 Apr;59(4):484–488. doi: 10.1097/00007611-196604000-00025. [DOI] [PubMed] [Google Scholar]
  28. Whaley K., Pack A. I., Boyle J. A., Dick W. C., Downie W. W., Buchanan W. W., Gillespie F. C. The articular scan in patients with rheumatoid arthritis: a possible method of quantitating joint inflammation using radio-technetium. Clin Sci. 1968 Dec;35(3):547–552. [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES