Escalated conventional therapy for rheumatoid arthritis patients

M. D. Smith

Rheumatology Unit, Repatriation General Hospital, Daws Road, Daw Park, Adelaide, South Australia 5041, Australia

Correspondence to: M. Smith. E-mail: malcolm.smith{at}rgh.sa.gov.au

SIR, I would like to congratulate the authors on a very interesting paper recently published in Rheumatology [1]. I would also like to ask the authors for some additional information from their study. In Australia, the government limits health funding of treatment with anti-tumour necrosis factor therapies to those patients who have had a positive rheumatoid factor, whatever the level of positive rheumatoid factor and whenever the test was positive. If a patient is persistently seronegative for rheumatoid factor, even if they have erosions on X-ray, they are not eligible for government-funded treatment with anti-tumour necrosis factor therapies. This is because they hold the view, which I believe is not evidence-based, that only seropositive rheumatoid arthritis patients develop severe, destructive disease.

Could the authors extract from their data whether either a positive rheumatoid factor or presence of joint erosions on X-ray or both are predictors of patients going on to treatment with anti-tumour necrosis factor therapies?

The author has declared no conflict of interest.

References

  1. Bingham SJ, Buch MH, Tenant A, Emery P. The impact of escalating conventional therapy in rheumatoid arthritis patients referred for anti-tumour necrosis factor-{alpha} therapy. Rheumatology 2004;43:364–8.[Abstract/Free Full Text]
Accepted 28 May 2004





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