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February 1, 1965

Effect of Norethynodrel in Rheumatoid Arthritis

Author Affiliations

Los Angeles

New York

JAMA. 1965;191(5):419-420. doi:10.1001/jama.1965.03080050065026

To the Editor:—  The report by Gilbert et al in the Negative Results section (JAMA190:235 [Oct 19] 1964) on norethynodrel with mestranol provides a feeble basis for rejecting the earlier observation1 that drug-induced pseudopregnancy alleviates rheumatoid arthritis in women. The inclusion of four males in the series of 17 patients may constitute a parallel study, but since the results are not given separately by sex, these cases simply impair the test of the primary hypothesis. Likewise, the inclusion of five patients receiving titrated doses of other steroid hormones obscures interpretation of results. Decrease in corticoid requirements in all five patients may have been permitted by partial suppression of the rheumatoid process by norethynodrel, with resultant masking of clinical response.Regarding the study design, assignment of treatment "on an alternate basis" is not equivalent to randomized assignments, and since improvement appeared only in the group receiving the drug

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