Nialamide as a "Steroid Sparing" Agent in the Treatment of Rheumatoid Arthritis

Abstract

The efficacy of nialamide as a "steroid sparing" agent in the treatment of rheumatoid arthritis has been studied in 30 patients by a double-blind controlled trial. The patients received 50 mg nialamide 3 times daily, or a placebo, in addition to their normal dose of corticosteroid for 4 weeks; the dose of corticosteroid was then reduced by one-third and nialamide or the placebo continued in the same dose. Arthritic and psychiatric assessments were made at the beginning of the trial and at the end of each 4-week period. There was no evidence that nialamide acted as a steroid sparing agent. A striking correlation was found, however, between psychiatric and subjective arthritic changes, and it is suggested that any apparent steroid sparing action reported by others may be due to elevation of mood rather than to a direct biochemical interaction.