Cade R, Stein G, Pickering M, Schlein E, Spooner G
South Med J. 1976 Apr;69(4):388-92. doi: 10.1097/00007611-197604000-00003.
Sixteen patients with classical rheumatoid arthritis which had been present for longer than two years, representing anatomic stages II-IV, were treated with azathioprine in doses of 50 to 175 mg/day. They were followed up for up to six years. Using the criterion of ability to work, 93% of the patients improved markedly during the time observed. Complement levels were low before treatment and tended to stabilize within the normal range as the disease became less active. Erythrocyte sedimentation rate (ESR) fell during therapy but changes in ESR did not correlate well with the patients' clinical states. Titers of rheumatoid agglutinins showed little change after as long as six years of therapy. When all patients were stable a double-blind cross-over study, using a placebo tablet, was instituted. Fifteen of 16 patients had a marked exacerbation of disease activity after receiving placebo for three to eight weeks. When azathioprine was reinstituted, gradual improvement again occurred so that all patients were back to their asymptomatic or mildly symptomatic state within seven months.
16例患经典型类风湿关节炎两年以上、处于解剖学分期II - IV期的患者，接受了剂量为每日50至175毫克的硫唑嘌呤治疗。对他们进行了长达六年的随访。根据工作能力标准，93%的患者在观察期内有明显改善。治疗前补体水平较低，随着疾病活动度降低，补体水平趋于稳定在正常范围内。治疗期间红细胞沉降率（ESR）下降，但ESR的变化与患者的临床状态相关性不佳。类风湿凝集素滴度在长达六年的治疗后变化不大。当所有患者病情稳定后，开展了一项使用安慰剂片的双盲交叉研究。16例患者中有15例在接受安慰剂治疗三至八周后疾病活动度明显加剧。重新使用硫唑嘌呤后，病情又逐渐改善，所有患者在七个月内恢复到无症状或症状轻微的状态。
