January 1990

Methotrexate in Rheumatoid ArthritisImpact on Quality of Life Assessed by Traditional Standard-Item and Individualized Patient Preference Health Status Questionnaires

Author Affiliations

From the Division of Rheumatology, Department of Medicine (Drs Tugwell and Buchanan and Mrs Grace), and the Department of Clinical Epidemiology and Biostatistics (Drs Tugwell and Goldsmith and Ms Bennett), McMaster University, Hamilton, and the Rheumatic Disease Unit, Wellesley Hospital, Toronto (Dr Bombardier), Canada; the Departments of Internal Medicine (Drs Williams and Ward) and Family and Community Medicine (Dr Egger), University of Utah School of Medicine, Salt Lake City; the University of Alabama, Birmingham (Dr Alarcon); the Department of Medicine, State University of New York, SUNY Health Sciences Center at Brooklyn (Dr Guttadauria); the National Institute of Arthritis and Musculoskeletal Diseases, Bethesda (Ms Yarboro), and the Rheumatology Division, The Johns Hopkins University at Good Samaritan Hospital, Baltimore (Dr Billingsley), Md; the Division of Rheumatic and Genetic Diseases, Duke University Medical Center, Durham, NC (Dr Polisson); the Division of Rheumatology, School of Medicine, UCLA (Dr Szydlo); the Division of Immunology, University of Cincinnati Medical Center, Ohio (Dr Luggen); and the Department of Medicine, Harborview Medical Center, Seattle, Wash (Dr Marks).

Arch Intern Med. 1990;150(1):59-62. doi:10.1001/archinte.1990.00390130073009

• In a double-blind, randomized trial of methotrexate vs placebo in rheumatoid arthritis, the effect of treatment on physical, social, and emotional function was measured in two different ways: the same, standard measurements in all patients, and individualized measurements selected by the patients at the start of the trial as representing the functions they most wanted to have improved by treatment. On the standard measurements, methotrexate-treated patients fared better than placebo-treated patients in their physical, social, and emotional function by 11%, 5%, and 6%, respectively, results that, although statistically significant, were small. However, methotrexate-treated patients were 29% better in the individualized measures, a result that was both highly statistically significant and greater than the differences in the standard measurements or in joint counts, grip strength, proximal interphalangeal joint circumference, morning stiffness, or walking time. Because the individualized measurements were as efficient as the best direct joint examination measures, yet reflected

First Page Preview View Large
First page PDF preview
First page PDF preview