Evidence map›Paper›PMID 31630117›Full record

Trial reportAnnals of the rheumatic diseases2020

Sustained discontinuation of infliximab with a raising-dose strategy after obtaining remission in patients with rheumatoid arthritis: the RRRR study, a randomised controlled trial.

Yoshiya Tanaka, Koji Oba, Takao Koike, Nobuyuki Miyasaka, Tsuneyo Mimori, Tsutomu Takeuchi, Shintaro Hirata, Eiichi Tanaka, Hidekata Yasuoka, Yuko Kaneko and 14 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of the rheumatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors at 17 institutions in 1 country.

Yoshiya TanakaDepartment of the First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan tanaka@med.uoeh-u.ac.jp.ORCID 0000-0002-0807-7139
Koji ObaClinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Takao KoikeDepartment of Clinical Immunology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Nobuyuki MiyasakaDepartment of Rheumatology, Tokyo Medical and Dental University, Tokyo, Japan.
Tsuneyo MimoriDepartment of Rheumatology, Ijinkai Takeda General Hospital, Kyoto, Japan.
Tsutomu TakeuchiDepartment of Rheumatology, Keio University, School of Medicine, Tokyo, Japan.
Shintaro HirataDepartment of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan.ORCID 0000-0002-2474-9943
Eiichi TanakaDepartment of Rheumatology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Hidekata YasuokaDepartment of Rheumatology, Keio University, School of Medicine, Tokyo, Japan.
Yuko KanekoDepartment of Rheumatology, Keio University, School of Medicine, Tokyo, Japan.
Kosaku MurakamiDeapartment of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan.
Tomohiro KogaDepartment of Immunology and Rheumatology, Nagasaki University, Nagasaki, Japan.
Kazuhisa NakanoDepartment of the First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Koichi AmanoDepartment of Rheumatology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Kazuyasu UshioUshio Clinic, Osaka, Japan.
Tatsuya AtsumiDepartment of Clinical Immunology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Masayuki InooUtazu Hama Clinic, Ayauta-gun, Kagawa, Japan.
Kazuhiro HattaDepartment of General Medicine, Tenri Hospital, Tenri, Japan.
Shinichi MizukiThe Centre for Rheumatic Diseases, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan.
Shouhei NagaokaDepartment of Rheumatology, Yokohama Minami Kyosai Hospital, Yokohama, Japan.
Shinichiro TsunodaDivision of Rheumatology, Hyogo College of Medicine, Nishinomiya, Japan.
Hiroaki DobashiDivision of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Miki, Japan.
Nao HorieClinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Norihiro SatoClinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Hokkaido University Hospital · JPKeio University · JPHokkaido University · JPUniversity of Occupational and Environmental Health Japan · JPHiroshima University Hospital · JPHyogo Medical University · JPIjinkai Takeda General Hospital · JPKagawa University · JPKyoto University · JPMatsuyama Red Cross Hospital · JPNagasaki University · JPOsaka Nishi Clinic · JPSocial Insurance Saitama Chuo Hospital · JPTenri Hospital · JPTokyo Medical and Dental University · JPTokyo Women's Medical University · JPYokohama Minami Kyosai Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aim of this study is to determine whether the 'programmed' infliximab (IFX) treatment strategy (for which the dose of IFX was adjusted based on the baseline serum tumour necrosis factor α (TNF-α)) is beneficial to induction of clinical remission after 54 weeks and sustained discontinuation of IFX for 1 year.

methodsIn this multicentre randomised trial, patients with IFX-naïve rheumatoid arthritis with inadequate response to methotrexate were randomised to two groups; patients in programmed treatment group received 3 mg/kg IFX until week 6 and after 14 weeks the dose of IFX was adjusted based on the baseline levels of serum TNF-α until week 54; patients in the standard treatment group received 3 mg/kg of IFX. Patients who achieved a simplified disease activity index (SDAI) ≤3.3 at week 54 discontinued IFX. The primary endpoint was the proportion of patients who sustained discontinuation of IFX at week 106.

resultsA total of 337 patients were randomised. At week 54, 39.4% (67/170) in the programmed group and 32.3% (54/167) in the standard group attained remission (SDAI ≤3.3). At week 106, the 1-year sustained discontinuation rate was not significantly different between two groups; the programmed group 23.5% (40/170) and the standard group 21.6% (36/167), respectively (2.2% difference, 95% CI -6.6% to 11.0%; p=0.631). Baseline SDAI <26.0 was a statistically significant predictor of the successfully sustained discontinuation of IFX at week 106.

conclusionProgrammed treatment strategy did not statistically increase the sustained remission rate after 1 year discontinuation of IFX treatment.

Indexed as

DeprescriptionsAdultAgedAged, 80 and overArthritis, RheumatoidFemaleHumansInfliximabMaleMiddle AgedRemission InductionTreatment OutcomeTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsYoung AdultInfliximabTumor Necrosis Factor-alphaTumor Necrosis Factor Inhibitorsinfliximabrandomized controlled trialsremissionrheumatoid arthritisTNF-α

Identifiers

PMID31630117
PMCPMC6937411
OpenAlexW2980610050

What OpenQuestion holds

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Registered trials

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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.