eLetters

322 e-Letters

  • Confounding by indication invalidates most observational studies on side effects of glucocorticoids
    Maarten Boers

    Dear Editor,

    We read with interest the paper by Dixon et al, and the associated paper published in 2011 on the risk of infection in glucocorticoid (GC) use in RA.1,2 Whilst their analyses add somewhat to the evidence of the risk of infection caused by GC in RA, because they are retrospective observational studies of uncontrolled treatment decisions we have strong reservations on the extent of their interpretations...

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  • Tocilizumab for patients with giant cell arteritis: generating pathogenic hypothesis
    Francisco J. Fernandez-Fernandez

    Dear Editor,

    In October 2011, Beyer and colleagues published an interesting article on the use of tocilizumab as rescue treatment for 3 patients with giant cell arteritis(1). Their patients had a high systemic inflammatory response and involvement of the aorta and its main branches, showing Takayasu-like features. The authors noted that, perhaps, tocilizumab might be less effective for 'classical' giant cell arteri...

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  • HMGB-1 in ANCA-associated vasculitis (AAV):correlation with disease manifestations
    Annette Bruchfeld

    Dear editor,

    Recently Henes et al reported that serum levels of the proinflammatory mediator high mobility group box-1 protein (HMGB1) were elevated and showed a significant correlation with the burden of granulomatous inflammation in patients with Granulomatosis with polyangiitis (GPA or Wegener) (1). The same group has previously published data suggesting that HMGB1 is a marker of GPA and that HMGB1 is not detec...

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  • Does current evidence support the use of a lower and cheaper dose of rituximab in RA?
    Markus Bredemeier

    Dear editor,

    Rituximab (RTX) is an effective alternative for rheumatoid arthritis patients that failed or are unable to tolerate treatment with anti-TNF agents. The approved dose of RTX for rheumatoid arthritis is 1000 mg given 14 days apart. However, an analysis of the results of recent studies may indicate that the 500 mg dose is equally effective and less expensive.

    The 2 year results of the IMAGE...

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  • Mycophenolate versus azathioprine: which one is better for treatment of lupus nephritis?
    Wang-Dong Xu

    Dear editor,

    We read with interest the article by Houssiau, et al [1], which provided evidence that mycophenolate mofetil (MMF) was not significantly superior to azathioprine (AZA) in preventing renal flares in European patients with lupus nephritis (LN), with a renal relapse rate of 19%, 25% in the MMF, AZA group, respectively. However, inconsistency exists compared with other studies up to now [2-5]. Recently...

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  • Preemptive Treatment of Hepatitis B in Patients of Rheumatoid Arthritis and Spondyloarthritis Using Tumor Necrosis Factor-alpha Antagonist: an Individualised Management.
    James CC Wei

    Dear editor,

    We are writing in response to 'Kinetics of viral loads and risk of hepatitis B virus reactivation in hepatitis B core antibody-positive rheumatoid arthritis patients undergoing anti-tumor necrosis factor alpha therapy' by Lan, et al[1]. We performed a similar retrospective study in the rheumatoid arthritis and the spondyloarthritis patients comorbid with chronic hepatitis B treated by anti-tumor ne...

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  • Non-melanoma skin cancer risk in patients with rheumatoid arthritis on tumor necrosis factor inhibitors
    PRABHA RANGANATHAN

    Dear Editor,

    We read with interest the meta-analysis of registries and prospective observational studies conducted by Mariette and colleagues on the risk of malignancies in patients with rheumatoid arthritis (RA) treated with tumor necrosis factor (TNF) antagonists. (1) Their meta-analysis highlights the complexity surrounding this important clinical issue, when TNF antagonists are considered for patients with RA with...

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  • Is new evidence for the role of leptin playing in increasing risk of atherosclerosis in systemic lupus erythematosus?
    Wang-Dong Xu

    Wang-Dong Xu, Yu-Jing Zhang, Hai-Feng Pan, Dong-Qing Ye*

    Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China;

    *Correspondence: Dong-Qing Ye, M.D, Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China,

    E-mail: yd...

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  • Causality or Confounding by Indication: Do Statins Promote Development of Rheumatoid Arthritis? Comment on the Article by de Jong et al.
    Inge A. van den Oever

    Dear Editor,

    We read with interest the retrospective case-control study by de Jong et al.(1) The authors found an intriguing association between statin use and development of rheumatoid arthritis (RA). Some comments regarding the methodology and authors statements, may be appropriate.

    Evaluating treatment effects in observational studies can be problematic as prognostic factors influencing treatment decisions...

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  • Calcaneal enthesial reaction and "divots" lack specificity
    Bruce M. Rothschild

    Dear Editor,

    The study by Feydy and colleagues1 clearly evidences the importance of controls for assessment of the significance of clinical/radiologic observations/signs. Their eloquent study appropriately challenges the preconceived notion that enthesitis or enthesial reaction is an identifier for spondyloarthropathy2-5 and confirms the perceptions derived from studies of human skeletal collections.6,7 Those studies...

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