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Visualisation of structural damage as a surrogate marker of radiographic progression in patients with rheumatoid arthritis
  1. Alexander Pfeil1,
  2. Peter Oelzner1,
  3. Diane M Renz2,
  4. Gabriele Lehmann1,
  5. Gunter Wolf1,
  6. Joachim Boettcher3
  1. 1Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany
  2. 2Department of Diagnostic Radiology, Charite University Medicine, Berlin, Campus Virchow Clinic, Berlin, Germany
  3. 3Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum Gera, Gera, Germany
  1. Correspondence to Dr Alexander Pfeil, Department of Internal Medicine III, Jena University Hospital-Friedrich, Schiller University Jena, Erlanger Allee 101, Jena 07747, Germany; alexander.pfeil{at}med.uni-jena.de

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The article published by Landewe et al1 offers novel insights to assess the benefits of new therapeutic strategies in rheumatoid arthritis (RA), which focus more on (the visualisation of) structural integrity rather than the inhibition of radiographic progression.1 The authors clearly outline the three major problems of the common superiority study designs: (1) differences in progression are too small, (2) effective disease-modifying antirheumatic drugs used in the control group result in levels of radiographic progression, which are too low and (3) the length of placebo treatment is limited to 3 months preventing an exploration of radiological …

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