The coprimary end points at month @ were the mean change from baseline in the van der Heijde modified total Sharp score ( which ranges from @ to @ , with higher scores indicating greater structural joint damage ) and the proportion of patients with an American College of Rheumatology ( ACR ) @ response ( @ % reduction in the number of both tender and swollen joints and @ % improvement in three of five other criteria : the patient 's assessment of pain , level of disability , C-reactive protein level or erythrocyte sedimentation rate , global assessment of disease by the patient , and global assessment of disease by the physician ) .