REPORT

Using estimated yearly progression rates to compare radiographic data across recent randomised controlled trials in rheumatoid arthritis

V Strand¹, R Landéwé², D van der Heijde²

¹ Stanford University, Division of Immunology, Palo Alto, CA, USA
² Department of Internal Medicine, Division of Rheumatology, University Hospital Maastricht, Maastricht, The Netherlands.

Correspondence to:
Correspondence to:
Dr V Strand, 306 Ramona Road, Portola Valley, CA 94028, USA;
vstrand@aol.com

Keywords: rheumatoid arthritis; randomised controlled trials; radiographic damage

Abbreviations: CRP, C reactive protein; IL1Ra, interleukin 1 receptor antagonist; RCTs, randomised controlled trials

The first 150 words of the full text of this article appear below.

This review is based on publications and presented abstracts from six randomised controlled trials (RCTs) in the treatment of rheumatoid arthritis assessing treatment effects on radiographic measures of disease progression. Each used the Sharp scoring method to assess changes in erosions and joint space narrowing from baseline.^1–3 These RCTs showed that the newly approved synthetic and biological disease modifying antirheumatic drugs, leflunomide, infliximab, etanercept, and Anakinra, were effective, and confirmed the efficacy of sulfasalazine and methotrexate in retarding disease progression.^4–13 Provided that sample sizes are adequate, randomisation within a protocol accounts for the heterogeneity of disease populations and yields linear progression rates over time.¹⁴

Each RCT enrolled a unique patient group with significantly different demographics and baseline disease characteristics across the trials, although well balanced within each protocol. Because of these population differences it is not appropriate to compare directly changes in total composite (Sharp) scores across trials. However, it . . . [Full text of this article]

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