Abstract
To the Editor:— The report by Gilbert et al in the Negative Results section ( JAMA 190 :235 [Oct 19] 1964) norethynodrel with mestranol provides a feeble for rejecting the earlier observation 1 that drug-induced pseudopregnancy alleviates rheumatoid arthritis in women. The inclusion of four males in the series of 17 patients may constitute a parallel study, but since the results are not given separately by sex, these cases simply impair the test of the primary hypothesis. Likewise, the inclusion of five patients receiving titrated doses of other steroid hormones obscures interpretation of results. Decrease in corticoid requirements in all five patients may have been permitted by partial suppression of the rheumatoid process by norethynodrel, with resultant masking of clinical response. Regarding the study design, assignment of treatment on an alternate basis is not equivalent to randomized assignments, and since improvement appeared only in the group receiving the drug
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