Characteristics of included studies
| Baseline characteristics | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Study | N | RF+ (%) | Erosions (%) | Disease duration (mean, years) | Study type* | Intervention and comparison | Duration (months) | Outcome measure | ITT | Quality score |
| Ahern et al8 | 38 | 63 | 76 | 11.3 | RCT, single blind | D-pen (dose reduced by 125 mg/month) vs D-pen (at initial dose) | 12 | Flare | Not mentioned | + |
| De Silva and Hazleman9 | 32 | 66 | – | 16 | RCT, double blind | Placebo vs AZA (at initial dose) | 8 | Clinical deterioration | Not mentioned | + |
| Gøtzsche et al7 | 114 | – | 82 | 12 | RCT, double blind | Placebo vs MTX, pen or SSZ (at initial dose) | 6 | Treatment failure | Yes | ++ |
| Kremer et al11 | 10 | 60 | – | >40 months | RCT, double blind | Placebo vs MTX (at initial dose) | 1 | Flare | Not mentioned | + |
| ten Wolde et al12 | 285 | 66 | – | 16 | RCT, double blind | Placebo vs DMARD (at initial dose) | 12 | Flare | Not mentioned | + |
| Van der Leeden et al14 | 24 | – | 100 | – | RCT, double blind | Placebo (1/100 gold) vs IM gold (at initial dose) | 24 | Flare | Not mentioned | + |
| Fleischmann et al6† | 210 | – | – | 10.4 | Case series | IFX with MTX dose tapered (down to 5 mg/week) after clinically important improvement | 12 | Changed joint counts | NA | NA |
| Bacon et al10† | 38 | – | – | 14 | Case series | Gradual withdrawal of prednisolone (1 mg/month) | Unknown | Flare | NA | NA |
| Tishler et al13† | 15 | 80 | – | 7.4 | Case series | MTX dose unchanged but regimen reduced from once/week to once/fortnight | 12 | Flare | NA | NA |
↵* For randomised controlled trials (RCT), a quality score of ‘++’ means good quality (all three of the following were present: adequate randomisation and blinding plus intention-to-treat (ITT) analysis). A score of ‘+’ means moderate quality (one or two of these were missing or not mentioned) and a score of ‘–‘means poor quality (all three were missing or not mentioned).
↵† These trials were not included in the meta-analysis as they are case series.
AZA, azathioprine; DMARD, disease-modifying antirheumatic drug; D-pen, D-penicillamine; IFX, infliximab; IM, intramuscular; MTX, methotrexate; pen, penicillamine; RF+, rheumatoid factor positive; SSZ, sulphasalazine.