Rheumatology Vol. 43 No. 9 © British Society for Rheumatology 2004; all rights reserved
Letter to the Editor |
Escalated conventional therapy for rheumatoid arthritis patients
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
- Bingham SJ, Buch MH, Tenant A, Emery P. The impact of escalating conventional therapy in rheumatoid arthritis patients referred for anti-tumour necrosis factor-
therapy. Rheumatology 2004;43:364–8.[Abstract/Free Full Text]
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