Recent clinical trials in the rheumatic diseases

This paper reviews clinical trials that have been published during the course of the past year on the rheumatologic diseases. The greatest number of clinical trials were done in rheumatoid arthritis. These trials show promising results for combination therapy with disease-modifying antirheumatic drugs, whereas results of studies with monoclonal antilymphocyte antibodies have been disappointing. The role of oral collagen remains to be defined. Nonsteroidal anti-inflammatory drugs with selective cyclooxygenase-2 (Cox-2) inhibition may have a more favorable toxicity profile and are likely to find wide use. As adjuvant therapy, trimethoprim-sulfamethoxazole appears to be useful in preventing relapses in Wegener's granulomatosis, and patients develop fewer infections. With the exception of juvenile rheumatoid arthritis, intravenous immunoglobulin therapy appeared ineffective in the diseases studied. The inclusion of more standardized and disease-specific outcome measures has enhanced the quality of clinical trials in rheumatology and their applicability to rheumatologic practice.