van Kerckhove C, Giannini E H, Lovell D J
Children's Hospital Medical Center, University of Cincinnati, Ohio 45229.
Arthritis Rheum. 1988 Oct;31(10):1252-8. doi: 10.1002/art.1780311006.
We calculated the time required for therapeutic benefit to become apparent following initiation of treatment with D-penicillamine (DP), hydroxychloroquine (HCQ), or placebo (each administered concomitantly with a nonsteroidal antiinflammatory drug) using data from a double-blind, randomized 12-month trial in 162 patients with juvenile rheumatoid arthritis. Using previously published criteria to classify the outcome, we found that 60% of the HCQ group, 46% of the DP group, and 39% of the placebo group responded favorably after 12 months of therapy. Data from examinations between the initial and final assessments were used to determine when the response first occurred. Approximately 50% of all patients who showed improvement at 12 months had already done so by 2 months. After 6 months, 96% of the DP group, 88% of the HCQ group, and 85% of the placebo group responders had met the criteria for response. The average time until response was attained was 105 days for the DP group, 129 days for the HCQ group, and 140 days for the placebo group. Our results indicate that a favorable response to these slow-acting antirheumatic drugs is unlikely if improvement has not occurred within the first 6 months of therapy.
我们利用一项针对162例青少年类风湿性关节炎患者的双盲、随机、为期12个月试验的数据，计算了开始使用D-青霉胺（DP）、羟氯喹（HCQ）或安慰剂（每种药物均与一种非甾体抗炎药联合使用）治疗后，治疗效果开始显现所需的时间。根据先前发表的标准对结果进行分类，我们发现治疗12个月后，HCQ组有60%、DP组有46%、安慰剂组有39%的患者反应良好。利用初始评估和最终评估之间的检查数据来确定反应首次出现的时间。在12个月时显示病情改善的所有患者中，约50%在2个月时就已出现改善。6个月后，DP组、HCQ组和安慰剂组中96%、88%和85%的有反应患者达到了反应标准。DP组达到反应的平均时间为105天，HCQ组为129天，安慰剂组为140天。我们的结果表明，如果在治疗的前6个月内未出现病情改善，那么对这些慢作用抗风湿药物出现良好反应的可能性不大。
