Chloroquine in rheumatoid arthritis; a double blindfold trial of treatment for one year.

Since the preliminary report on the use of mepacrine in the treatment of rheumatoid arthritis (Freedman and Bach, 1952), there has been a gradual appreciation of the value of 4-amino quinolone compounds for this condition. Many papers have appeared (Forestier and Certonciny, 1954; Scherbel, Schuchter, and Harrison, 1957; Erlendsson, 1958; Fuld and Horwich, 1958), but controlled trials have been few. The first (Freedman, 1956) dealt with 66 patients each observed for a period of 16 weeks. The finding that the chloroquine-treated patients did better than the controls was confirmed by trials undertaken by Rinehart, Rosenbaum, and Hopkins (1957), Cohen and Calkins (1958), and Kuipers (1959), in none of which was the period of comparison longer than 26 weeks. Bagnall (1957), convinced of the value of these drugs, abandoned his intention to conduct a controlled trial and published his findings of 4 years' treatment of patients, the longest series yet reported. With one equivocal exception (La Tona and Norcross, 1959), there has been widespread approbation by all authors for these compounds. The present report deals with observations in a double blindfold trial begun in 1956 in a group of patients each of whom was treated for a period of one year.