Radiological evaluation of erosions: a quantitative method for assessing long-term remittive therapy in rheumatoid arthritis.

1 The most reliable method for evaluating possible remission-inducing properties in a drug is to measure how well it prevents the appearance of new erosions in serial X-rays of the hands. 2 I have reviewed the literature on the development, over the last 25 years, of a standard method for quantitatively assessing the progress of erosions radiologically. 3 The only drugs thus far shown to be genuinely remission-inducing are cyclophosphamide, high-dose penicillamine, and (most consistently over several decades) gold-thiols, all drugs with life-threatening toxicity. 4 The search for a non-steroidal drug with remission-inducing properties is crucial in our efforts to find a safe drug to control the progression of rheumatoid arthritis.