Evidence map›Paper›PMID 25079933›Full record

Trial reportBMJ open2014

Rheumatoid factor and anti-CCP do not predict progressive joint damage in patients with early rheumatoid arthritis treated with prednisolone: a randomised study.

Ingiäld Hafström, Inga-Lill Engvall, Johan Rönnelid, Annelies Boonen, Désirée van der Heijde, Björn Svensson, BARFOT study group

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Ingiäld HafströmRheumatology Unit, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden.
Inga-Lill EngvallRheumatology Unit, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden.
Johan RönnelidDepartment of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Annelies BoonenDepartment of Internal Medicine, Division of Rheumatology, University Hospital, and CAPHRI Research Institute Maastricht, Maastricht, The Netherlands.
Désirée van der HeijdeDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Björn SvenssonDepartment of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.
BARFOT study group
Karolinska University Hospital · SELeiden University Medical Center · NLLund University · SEMaastricht University · NLUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo analyse if predictors of radiographic progression differ between patients treated with or without prednisolone in early rheumatoid arthritis (RA). Radiographs of hands and feet were assessed using the modified Sharp/van der Heijde score and radiographic progression was defined as an increase in the total Sharp score above 5.8 (the smallest detectable change).

designProspective, randomised study of patients with early RA.

settingSecondary level of care; six participating centres from southern Sweden; both urban and rural populations.

participantsIn all, 225 patients, 64% women, with a diagnosis of RA according to the American College of Rheumatology criteria, were included if they were between 18 and 80 years of age and had a disease duration of less than 1 year.

interventionThe patients were randomised to 7.5 mg prednisolone daily for 2 years (P-group; n=108) or no prednisolone (NoP-group; n=117) when they started with their first disease-modifying anti-rheumatic drug and were prospectively followed for 2 years.

resultsThe frequency of patients with radiographic progression after 2 years was 26% in the P-group and 39% in the NoP-group (p=0.033). Relevant interactions between treatment and rheumatoid factor (RF) (p=0.061) and between treatment and anti-cyclic citrullinated peptide 2 (anti-CCP) (p=0.096) were found. RF and anti-CCP independently predicted radiographic progression only in the NoP-group, OR (95% CI) 9.4 (2.5 to 35.2), p=0.001 and OR (95% CI) 8.7 (2.5 to 31.3), p=0.001, respectively.

conclusionsThe presence of RF and anti-CCP predicted radiographic progression in patients not treated with prednisolone but failed to predict progression in patients treated with this drug. The data suggest that early treatment with prednisolone may modulate not only inflammation but also autoimmunity-associated pathogenetic mechanisms. TRIAL REGISTRATION NUMBER: ISRCTN20612367.

Indexed as

AdultAgedAged, 80 and overAnti-Inflammatory AgentsAntirheumatic AgentsArthritis, RheumatoidBiomarkersDisease ProgressionFemaleFootHandHumansLongitudinal StudiesMaleMiddle AgedPeptides, CyclicAnti-Inflammatory AgentsAntirheumatic AgentsBiomarkerscyclic citrullinated peptidePeptides, CyclicPrednisoloneRheumatoid FactorRheumatology

Identifiers

PMID25079933
PMCPMC4120364
OpenAlexW2124094613

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.