Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • COVID-19 and Rheumatology
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • COVID-19 and Rheumatology
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on YouTube
  • Follow jrheum on Instagram
  • Follow jrheum on RSS
LetterLetter

Effects of Co-medication with Glucocorticoids in Biologics Trials

MAARTEN BOERS
The Journal of Rheumatology November 2018, 45 (11) 1605; DOI: https://doi.org/10.3899/jrheum.180151
MAARTEN BOERS
Professor of Clinical Epidemiology, Department of Epidemiology and Biostatistics, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands. E-mail:
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for MAARTEN BOERS
  • For correspondence: m.boers@VUMC.NL

To the Editor:

I read with interest the article “Effect of Glucocorticoids on the Clinical and Radiographic Efficacy of Tofacitinib in Patients with Rheumatoid Arthritis: A Posthoc Analysis of Data from 6 Phase III Studies1.”

I am pleased with the finding of a numerically beneficial effect of current co-treatment with glucocorticoids on radiographic progression in patients treated only with methotrexate (or placebo), because this strengthens earlier observations we made in this journal2.

The authors report that the differences between these groups were not statistically significant, but the article was not entirely clear on the analysis strategy. The difference was most apparent at 24 months, but the CI overlapped. Although overlapping CI do not preclude a significant difference3, from visual inspection of the figure, the degree of overlap supports the conclusion, and I assume the differences were also formally tested. However, I am not sure whether this difference at 24 months (and the CI) fully incorporated the information on the measurements taken at 6 and 12 months. In other words, did the mixed model analysis result in an overall assessment of the progression rate over 24 months, or were the timepoints tested separately? Optimal power to detect differences is only achieved if the former method was used.

Also, information is missing on the number of patients still taking placebo at 24 months, and on the treatment of the patients who started taking placebo but prematurely discontinued or were switched to active (or other) treatment per protocol. This information would help to further interpret the findings of this posthoc analysis.

REFERENCES

  1. 1.
    1. Charles-Schoeman C,
    2. van der Heijde D,
    3. Burmester GR,
    4. Nash P,
    5. Zerbini CA,
    6. Connell CA,
    7. et al.
    Effect of glucocorticoids on the clinical and radiographic efficacy of tofacitinib in patients with rheumatoid arthritis: a posthoc analysis of data from 6 phase III studies. J Rheumatol 2018;45:177–87.
  2. 2.
    1. Boers M,
    2. Aletaha D,
    3. Mela CM,
    4. Baker DG,
    5. Smolen JS
    . Glucocorticoid effect on radiographic progression in placebo arms of rheumatoid arthritis biologics trials. J Rheumatol 2016;43:1024–6.
  3. 3.
    1. Boers M
    . Null bar and null zone are better than the error bar to compare group means in graphs. J Clin Epidemiol 2004;57:712–5.

Content

  • First Release
  • Current
  • Archives
  • Collections
  • Audiovisual Rheum
  • COVID-19 and Rheumatology

Resources

  • Guide for Authors
  • Submit Manuscript
  • Author Payment
  • Reviewers
  • Advertisers
  • Classified Ads
  • Reprints and Translations
  • Permissions
  • Meetings
  • FAQ
  • Policies

Subscribers

  • Subscription Information
  • Purchase Subscription
  • Your Account
  • Terms and Conditions

More

  • About Us
  • Contact Us
  • My Alerts
  • My Folders
  • Privacy/GDPR Policy
  • RSS Feeds
The Journal of Rheumatology
The content of this site is intended for health care professionals.
Copyright © 2022 by The Journal of Rheumatology Publishing Co. Ltd.
Print ISSN: 0315-162X; Online ISSN: 1499-2752
Powered by HighWire