van der Heijde D M, van Riel P L, Nuver-Zwart I H, Gribnau F W, vad de Putte L B
Department of Rheumatology, University Hospital, Nijmegen, The Netherlands.
Lancet. 1989 May 13;1(8646):1036-8. doi: 10.1016/s0140-6736(89)92442-2.
The effects of hydroxychloroquine and sulphasalazine on progression of joint damage shown by X-rays were compared in a double-blind, randomised trial in 60 patients with rheumatoid arthritis not previously treated with slow-acting antirheumatic drugs. X-rays of the hands and feet at the start and after 24 and 48 weeks of treatment were available for 28 patients treated with hydroxychloroquine and 22 treated with sulphasalazine. Erosions and joint space narrowing were scored by a single observer unaware of treatment. At baseline there were no significant differences in demographic, clinical, or radiographic characteristics between the treatment groups. Patients withdrawn because of lack of effect were included in the analysis. The median number of erosions was lower in the sulphasalazine than the hydroxychloroquine group at 24 weeks of treatment (2.5 vs 10) and the difference was significant at 48 weeks (5 vs 16; p less than 0.02). The difference in median total score of joint damage was significant at 24 weeks (6.5 vs 17; p less than 0.02) and at 48 weeks (8 vs 33; p less than 0.02). The increase in number of erosions and total score was significantly greater in the hydroxychloroquine than the sulphasalazine group, both after 24 weeks and after 48 weeks of treatment.
在一项双盲随机试验中，对60例既往未接受过慢作用抗风湿药物治疗的类风湿关节炎患者，比较了羟氯喹和柳氮磺胺吡啶对X线所示关节损害进展的影响。28例接受羟氯喹治疗和22例接受柳氮磺胺吡啶治疗的患者有治疗开始时以及治疗24周和48周后的手足X线片。由一名对治疗不知情的观察者对侵蚀和关节间隙变窄进行评分。在基线时，治疗组之间在人口统计学、临床或影像学特征方面无显著差异。因无效而退出的患者纳入分析。在治疗24周时，柳氮磺胺吡啶组的侵蚀中位数低于羟氯喹组（2.5对10），在48周时差异显著（5对16；p<0.02）。关节损害总评分中位数的差异在24周时显著（6.5对17；p<0.02），在48周时也显著（8对33；p<0.02）。在治疗24周和48周后，羟氯喹组侵蚀数量和总评分的增加均显著大于柳氮磺胺吡啶组。
