ArticleNature reviews. Rheumatology2013
Creative trial design in RA: optimizing patient outcomes.
Article in Nature reviews. Rheumatology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Assessing the uncertainty of treatment outcomes in a previous systematic review of venous leg ulcer randomized controlled trials: Additional secondary analysis.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society · 2021Pooled it
- Innovative trial approaches in immune-mediated inflammatory diseases: current use and future potential.BMC rheumatology · 2021Article
- Trial designs using real-world data: The changing landscape of the regulatory approval process.Pharmacoepidemiology and drug safety · 2020Review
- Transforming clinical trials in rheumatology: towards patient-centric precision medicine.Nature reviews. Rheumatology · 2020Review
- Predictors, demographics and frequency of sustained remission and low disease activity in anti-tumour necrosis factor-treated rheumatoid arthritis patients.Rheumatology (Oxford, England) · 2019Article
- Synovial Tissue Heterogeneity in Rheumatoid Arthritis and Changes With Biologic and Targeted Synthetic Therapies to Inform Stratified Therapy.Frontiers in medicine · 2019Review
- In vivo therapeutic efficacy of TNFα silencing by folate-PEG-chitosan-DEAE/siRNA nanoparticles in arthritic mice.International journal of nanomedicine · 2018Article
- Biomarker-Guided Non-Adaptive Trial Designs in Phase II and Phase III: A Methodological Review.Journal of personalized medicine · 2017Review
- Daily practice feasibility and effectiveness of treating long-standing rheumatoid arthritis to target with synthetic disease-modifying antirheumatic drugs: a prospective cohort study.Clinical rheumatology · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
The rheumatology community has witnessed remarkable advances in the management of rheumatoid arthritis (RA) made possible by the development of highly effective biologic DMARDs. Robust randomized controlled trials of clinical efficacy, equipped with validated outcome measures, ensured these therapies could enter the clinical arena and thus substantially improve patient outcomes. Current management principles, which follow a 'treat-to-target' paradigm, advocate tight control of disease activity with the aim of achieving clinical remission. However, efficacy trials are not yet aligned with this approach, hampering patient recruitment. This impediment and the usual approach of inclusion of previously failed treatment arms (to protect methodological concerns) is prompting reappraisal of RA trial design and the consideration of more pragmatic studies that reflect real-life practice. In addition, the aspirations of the rheumatology community to strive for personalized medicine means innovative approaches to trial design are needed to complement the efficacy trial. This Review appraises the current trial landscape and provides insights and key concepts from other fields such as oncology as to the potential utility (as well as the limitations) of pragmatic trial designs such as adaptive trials and biomarker-driven trials.
Indexed as
Identifiers
23381561What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.