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Is IV infliximab better than IV methylprednisolone for the treatment of patients with RA when methotrexate fails?
  1. M D Smith1
  1. 1Rheumatology Unit, Repatriation General Hospital, Adelaide, South Australia
  1. Correspondence to:
    Dr M D Smith
    malcolm.smithrgh.sa.gov.au

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    A recent paper described a randomised comparative study of intravenous (IV) pulse methylprednisolone versus infliximab treatment in patients for whom methotrexate treatment had failed.1 The conclusions that infliximab treatment offered substantial benefits over IV methylprednisolone may be correct, but the design of the trial has resulted in a biased assessment in favour of IV infliximab treatment. In addition, the failure of the IV methylprednisolone treatment to alter significantly a number of clinical and laboratory measures, including serum C reactive protein levels, is at odds with published reports.2–7

    A comparison between the patient group in that …

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