HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) All Versions of this Article: ard.2005.044131v1 65/7/878    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pincus, T Articles by Cawkwell, G Search for Related Content PubMed PubMed Citation Articles by Pincus, T Articles by Cawkwell, G

Declines in number of tender and swollen joints in patients with rheumatoid arthritis seen in standard care in 1985 versus 2001: possible considerations for revision of inclusion criteria for clinical trials

¹ Division of Rheumatology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
² Jyväskylä Central Hospital, Jyvaskyla, Finland
³ Pfizer, Inc., New York, New York, USA

Correspondence to:
Correspondence to:
Professor T Pincus
Division of Rheumatology and Immunology, Vanderbilt University School of Medicine, 203 Oxford House, Box 5, Nashville, TN 37232-4500, USA; t.pincus{at}vanderbilt.edu

Objective: To analyse tender and swollen joint counts in three cohorts of patients with rheumatoid arthritis (RA), with a focus on the proportions of patients who had fewer than 6–12 tender or swollen joints, as possible evidence based information toward more generalisable inclusion criteria for current and future RA clinical trials.

Methods: Tender and swollen joint counts were analysed in three cohorts of patients with RA: 125 in 1985, 138 in 2000, and 232 with early RA in 2001.

Results: The median numbers of tender joints were 11, 2, and 4 in 1985, 2000, and in early RA in 2001, respectively. The median numbers of swollen joints were 12, 6, and 5 in 1985, 2000, and 2001, respectively. The numbers of tender joints among 28 assessed were 12, 6, 4, and 3 in 47%, 80%, 85%, and 90% of patients in 1985; 20%, 37%, 44%, and 49% in 2000; and 17%, 37%, 50%, and 58% in early RA in 2001. The numbers of swollen joints among 28 assessed were 12, 6, 4, and 3 in 51%, 78%, 86%, and 90% of patients in 1985; 20%, 50%, 64%, and 67% in 2000; and 14%, 46%, 58%, and 72% in 2001. The number of patients with 6 tender or swollen joints in 1985 was greater than the number with 3 joints in 2000 and in early RA in 2001.

Conclusion: Contemporary cohorts of patients seen in standard care have smaller numbers of tender and swollen joints than in previous times. These findings suggest that revision of inclusion criteria for numbers of tender and swollen joints in contemporary RA clinical trials might improve generalisability.

Abbreviations: DAS, Disease Activity Score; DMARD, disease modifying antirheumatic drug; RA, rheumatoid arthritis; SPERA, standard protocol to evaluate rheumatoid arthritis

Keywords: rheumatoid arthritis; core dataset; clinical trials; standard care; inclusion criteria

This article has been cited by other articles:

				A Finckh, H K Choi, and F Wolfe Progression of radiographic joint damage in different eras: trends towards milder disease in rheumatoid arthritis are attributable to improved treatment Ann Rheum Dis, September 1, 2006; 65(9): 1192 - 1197. [Abstract] [Full Text] [PDF]