eLetters

117 e-Letters

published between 2010 and 2013

  • EULAR advice against DMARD combination therapy, a major flaw.
    Niels A Graudal

    Dear Editor,

    In point 5 and 7-8 of the EULAR recommendations for the management of rheumatoid arthritis (1) the following statements are listed:
    1) In DMARD naive patients, irrespective of the addition of GCs, synthetic DMARD monotherapy rather than combination therapy of synthetic DMARDs may be applied.
    2) If the treatment target is not achieved with the first DMARD strategy, addition of a biological DMARD s...

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  • Intensive management of early RA leads to improvements in physical function.
    Duncan R Porter

    Dear Editor,

    Many thanks to Schoels et al for their very helpful systematic literature review of the evidence for treating RA to target [1]. However, I am concerned that the authors' discussion may lead readers to conclude erroneously that there is no evidence that treat to target, intensive management has a beneficial impact on physical function. In their discussion the authors state that 'Functional outcomes, reported...

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  • Has modified release prednisone any clinical advantage over immediate release prednisone in patients with rheumatoid arthritis?
    Bernard Bannwarth

    Dear Editor,

    I read with interest the editorial on modified release (MR) prednisone in patients with rheumatoid arthritis (RA)[1]. In brief, it can be inferred from available data that the only clinical advantage of MR prednisone over immediate release (IR) prednisone was a decrease in duration of morning stiffness [1]. Of note, patients received IR prednisone in the morning. Due to its short duration of action, low-dos...

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  • Re:Ankylosing spondylitis and myocardial infarction: a true association or selection bias?
    Michael Nurmohamed

    Dear Editor,

    De Vries and and Abbing-Karahagopian doubt the validity of the outcomes of our study and state that the myocardial infarction (MI) incidence rate in the control population might be underestimated, as they are much lower than rates found by Koek et al.

    However, there seems to be some misunderstanding about what these data represent. Our figures were derived from routine electronic medical records o...

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  • SF-36 improves in a 6-week RA trial: so what?
    Maarten Boers

    Dear Editor,

    Dear editor,

    I was disappointed in the publication of the concise report on the effects of an orally active Janus kinase (JAK) inhibitor on patient-reported outcomes in rheumatoid arthritis (RA). [1] JAK inhibition represents a new treatment option with potential in RA, so the results of the proof-of-concept trial were of interest, even though it lasted only 6 weeks; and these were duly published.[...

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  • Ankylosing spondylitis and myocardial infarction: a true association or selection bias?
    Frank de Vries

    Dear Editor,

    Dr Peters and co-workers conducted a case-control study, which showed that myocardial infarction (MI) was a 2-3-fold increased in patients with ankylosing spondylitis (AS). They compared AS patients to a sample of the Dutch general population. We are concerned that the association is (largely) explained by inappropriate selection of controls, instead of reflecting a causal pathway [1]. The authors compared...

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  • Running away from your own data
    John G Larkin

    Dear Editor,

    This is an interesting paper; however I was surprised at the vagueness of the conclusion. The authors showed a significantly increased 'ratio of lymphoma' with adalimumab (4.1) and infliximab (3.6) vs. entanercept (0.9). Unless some confounding variable is discovered, the conclusion would seem clear. Either adalimumab and infliximab predispose to lymphoma, or entanercept prevents it.

    The 'conclusion'...

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