Avouac B, Maheu E, Sallière D, Charpak Y, Le Loet X
Service de Rhumatologie, Hôpital Henri-Mondor, Créteil.
Rev Rhum Mal Osteoartic. 1990 Oct 30;57(9 ( Pt 2)):37S-43S.
The development of a drug for the fundamental treatment of osteoarthritis requires that its efficacy should be proven clinically. This implies that there must be a clear definition of the evaluation criterion (slowing down in the progression of osteoarthritic lesions). Marketing of a drug depends on the efficacy/safety relationship, but any assessment of the value of a fundamental treatment for osteoarthritis goes beyond the framework of a study of its efficacy. Its usefulness can be measured in terms of scales estimating the quality of life that are related to the osteoarthritic disease. Overall criteria, such as the level of maintenance treatment, can be used in comparative, randomized, double blinds trials. Pragmatic trials seem to afford a methodology which is suited to the evaluation of usefulness and therapeutic benefit. The basis of cost/effectiveness, cost/usefulness and cost/benefit studies relies on a comparison of the cost of osteoarthritis and its treatment with the benefits brought about by such treatment.
