MedicalResearch.com Interview with: Robert E. Garfield, PhD
Department of Perinatology, Division of Obstetrics and Gynecology
University Medical Centre Ljubljana, Slovenia
Costs of Unnecessary Admissions and Treatments for “Threatened Preterm Labor”MedicalResearch.com :What are the main findings of the study?Dr. Garfield: Unnecessary admissions and treatments for “threatened preterm labor” are still part of everyday clinical practice and contribute to exploding healthcare costs. This happens despite substantial evidence that measuring CL by trans-vaginal ultrasound can help to avoid needless interventions due to the high negative predictive values of this test.
MedicalResearch.com Interview with: Nisa M. Maruthur, MD, MHS
Assistant Professor of Medicine & Epidemiology
The Johns Hopkins University
Early Response to Preventive Strategies in the Diabetes Prevention Program
MedicalResearch.com: What are the main findings of the study?Dr. Maruther: For patients engaged in a lifestyle intervention to prevent diabetes, weight loss early on (at 6 months) is an extremely strong predictor of whether they will develop diabetes down the road. Even in the setting of substantial weight loss (>10%) at 6 months, it is still beneficial to lower fasting glucose. These results are unique in that we previously understood that weight loss over time (years) is important to prevent diabetes, but now we know the impact of early weight loss on longer-term diabetes risk.
MedicalResearch.com Interview with
Prof. Eyal Sheiner MD PhD
Soroka Medical Center, Israel
MedicalResearch.com: What are the main findings of the study?Dr. Sheiner:The study was aimed to investigate whether a history of preterm delivery (PTD) poses a risk for subsequent maternal long-term cardiovascular morbidity.
During the study period 47,908 women met the inclusion criteria; 12.5% (n=5992) patients delivered preterm. During a follow-up period of more than ten years, patients with PTD had higher rates of simple as well as complex cardiovascular events and higher rate of total cardiovascular related hospitalizations. A linear association was found between the number of previous PTD and future risk for cardiovascular hospitalizations (5.5% for two or more PTD, 5.0% for one PTD vs. 3.5% in the comparison group; P<0.001). The association remained significant for spontaneous vs. induced PTD and for early (<34 weeks) as well as late (34-36+6 weeks) PTD. In a Cox proportional hazards model that adjusted for pregnancy confounders such as labor induction, diabetes mellitus, preeclampsia and obesity, PTD was independently associated with cardiovascular hospitalizations (adjusted HR 1.4, 95% CI 1.2-1.6).
MedicalResearch.com Interview with: Ru-Rong Ji, PhD
Professor, Chief of Pain Research
Department of Anesthesiology and Neurobiology
Duke University Medical Center
Box DUMC 3094, Durham , NC 27710
MedicalResearch.com: What are the main findings of the study?Answer: We found the pro-resolution lipid mediator protectin D1 (PD1), derived from the fish oil DHA, can effectively prevent nerve injury-induced neuropathic pain. This treatment can also prevent nerve injury-induced neuroinflammation in the spinal cord (such as glial activation and expression of cytokines and chemokines, e.g., IL-1b, CCL2). These cytokines and chemokines are known to elicit pain.
Interview with: Dr Nicholas D Gollop BSc (Hons) MB BCh
Norfolk and Norwich University Hospital,
Norwich, NR4 7UY
Norfolk, United Kingdom
MedicalResearch.com: What are the main findings of the study?
We completed a best evidence topic in interventional cardiac surgery to investigate the significance of elevated markers of cardiac damage following percutaneous coronary intervention (PCI).
We compared the clinical and prognostic relevance of the elevation of creatinine kinase-myocardial band (CK-MB) and cardiac troponin (cTn) levels during peri-procedural period and post-procedural period, respectively, following an emergency or elective PCI.
We found in excess of 390 papers after a systematic literature search, of which 10 represented the best evidence to answer the clinical question. From the best evidence available we showed that the monitoring of cardiac biomarkers following PCI can provide important clinical information about the health of the myocardium, as well as prognostic information on short to mid-term outcomes of mortality up to 3 years.
MedicalResearch.com Interview with Dr. Frank Sellke, MD
Chief of cardiothoracic surgery and co-director of the Cardiovascular Institute at Rhode Island, The Miriam and Newport hospitals
MedicalResearch.com: What are the main findings of the study?Dr. Sellke: The main findings of the study are that outcomes of repair of an ascending aortic dissection are improved under a full moon compared to other phases of the moon. This was with regard to both mortality and length of hospital stay. Interestingly, there was no correlation with season of the year.
MedicalResearch.com Interview with: Dr. Bernard Rosner
Harvard School of Public Health
Professor in the Department of Biostatistics
Department of Biostatistics
Channing Laboratory 180 Longwood Avenue
Boston, Massachusetts 02115
MedicalResearch.com: What are the Main Findings of this study?Dr. Rosner: The risk of elevated blood pressure (BP) among children has increased 27% over a 13-year period based on a study among 11,636 children ages 8-17 seen in the NHANES study from 1988-2008. In NHANES III (1988-1994) the risk was 15.8% among boys and 8.2% among girls. In NHANES 1999-2008 (1999-2008) the risk was 19.2% among boys and 12.6% among girls.
Important risk factors for elevated BP were BMI, waist-circumference and sodium intake.
Risk approximately doubled for children in the highest age-sex-specific quartile of BMI vs. children in the lowest quartile
Risk approximately doubled for children in the highest age-sex-specific quartile of waist circumference vs. children in the lowest quartile
Risk increased 36% among children with dietary Na intake > 3450 mg/day vs. children with intake <2300 mg/day. Na intake was normalized per 2000 calories.
There were large increases in both mean BMI and mean waist circumference over the 13-year period, especially for girls.
MedicalResearch.com Interview with: Chiu-Fang Chou DrPH
Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion CDC, 4770 Buford Hwy, NE (K-10)
Atlanta GA 30341-3727
MedicalResearch.com: What are the main findings of the study?A: We estimated nearly 9 million people aged 40 years and older are visually impaired using the National Health and Nutrition Examination Survey. Three out of every four people aged 40 years and older with VI have uncorrected refractive error that could be easily corrected with simple glasses or contact lenses. The ocular disease most associated with visual impairment in our study sample was age-related macular degeneration. Finally, increasing age and low educational attainment were significant predictors of visual impairment.
MedicalResearch.com Interview with: Susan E. Swithers PhD
Professor, Behavioral NeuroscienceDepartment of Psychological Sciences and Ingestive Behavior Research Center
Purdue University, 703 Third Street
West Lafayette, IN 47907, USA
MedicalResearch.com: What are the main findings of the study?Dr. Swithers: The paper examined the last 5 years of studies that looked at risks associated with consuming artificially sweetened beverages like diet soda. These studies indicated that those who consume diet soda were at significantly greater risk for a variety of negative health outcomes like type 2 diabetes, coronary heart disease, hypertension and stroke, along with being more likely to gain excess weight. These effects might be due to a disruption of basic learned response. The idea is that normally things when things that taste sweet are consumed, the body receives calories and sugar. Our bodies can learn to prepare to deal with these calories and this sugar by starting up our digestive processes as soon as the sweet taste hits our mouth, for example by releasing hormones that not only help us regulate blood sugar, but also can contribute to feelings of fullness. When we consume diet sodas, the mouth gets the sweet taste, but the body doesn't get the calories or the sugar. The body may then learn that a sweet taste in the mouth doesn't always predict sugar and calories, so it makes adjustments in how many hormones it releases. So when we actually consume real sugar, the body doesn't produce the same kinds of physiological responses, which can lead to overeating, higher blood sugar, and over the long term could contribute to diseases like diabetes and stroke.
MedicalResearch.com Interview with:Aneel Bhangu, MBChB, MRCS and Douglas M. Bowley, FRCS
Royal Centre for Defense Medicine, Birmingham, England
MedicalResearch.com: What are the main findings of the study? Answer: Our study was a meta-analysis, which combined the findings from 8 randomized controlled trials that included a total of 623 patients. The key finding was that delayed primary skin closure (DPC) for contaminated and dirty abdominal incisions may reduce the rate of surgical site infection. However, due to high risk of bias from the included studies, including flaws in study design, definitive evidence is lacking.
We believe that this meta-analysis represents an exciting development in biomedical publishing; this was a true collaboration between US and UK military surgeons to examine an area of major concern and interest to surgeons everywhere. This work uses experience hard-won on the battlefields of Iraq and Afghanistan, combined with published surgical trials, to inform both future research activity as well as military and civilian surgical practice. This cross-fertilization of ideas is one positive consequence of all the sacrifice and suffering of recent conflicts.
MedicalResearch.com Interview with: Michael Belkin, MA, MD
Professor of Ophthalmology
Director, Ophthalmic Technologies Laboratory
Goldschleger Eye Research Institute
Tel Aviv University
Sheba Medical Center Tel Hashomer 52621
MedicalResearch.com: What are the main findings of the study?Dr. Belkin: Modern ophthalmic treatment, when freely availableis able to reduce the incidence of blindness, and presumably visual impairment considerably. In Israel the rate of new cases of blindness per 100.000 people [age adjusted] was reduced between 1999 and 2010 from 33.8 to 14.8, i.e., by over 56%. The reduction was in all major causes of blindness, Age-related Macular Degeneration (AMD), Glaucoma, Diabetic Retinopathy and Cataract. In the non-treatable retinal dystrophies such as retinitis pigmentosa, there was no significant changes over this period.
MedicalResearch.com Interview with: Andreas Beyerlein, PhD
Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, Germany
MedicalResearch.com What are the main findings of the study?Dr. Beyerlein: We identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for islet autoimmunity, which is known as a precursor of type 1 diabetes (T1D). We also found some evidence for short term effects of infectious events on development of autoimmunity.
MedicalResearch.com Interview with: Mark V. Paterno PT, PhD, MBA, SCS, ATC
Coordinator of Orthopaedic and Sports Physical Therapy
Associate Professor, Sports Medicine Biodynamics Center
Acting Scientific Director, Division of Occupational Therapy and Physical Therapy
Cincinnati Children's Hospital Medical Center
3333 Burnet Ave. MLC 10001
Cincinnati, OH 45229-3039
MedicalResearch.com: What are the main findings of the study?Dr. Paterno: Our study suggests that young patients (average age 16 y/o) who return to pivoting and cutting sports after Anterior cruciate ligament (ACL) reconstruction are 6 times more likely to suffer a second ACL injury than an individual with no prior history of ACL injury. In addition, females after ACL reconstruction may be more likely to injury their opposite limb than actually re-injure the same limb they initially hurt. Finally, when you look at the results of this 2 year outcome study in conjunction with the 1 year outcomes we published last year, it would appear that the greatest risk of suffering a second ACL injury is within the first several months after returning to sports.
MedicalResearch.com Interview with: Andrew Brenyo MD
Greenville University Health System
MedicalResearch.com: What are the main findings of the study?Dr. Brenyo: We found that BNP values at the time of CRT implant and during follow up predict response to CRT and subsequent risk of heart failure admission and death. BNP at implant and at subsequent times was strongly correlated with echocardiographic response to CRT-D along with predicting clinical outcome.
MedicalResearch.com Interview with Jill M. Norris, MPH, PhDColorado School of Public Health, University of Colorado, Aurora
MedicalResearch.com: What were the most significant findings? How do they relate to what was already known about this subject?Dr. Norris: One of the most intriguing findings is that if mothers are still breast-feeding when they introduce gluten-containing foods to their baby, they may reduce the risk for T1D. This is similar to a finding from a Swedish study that found that breast-feeding while introducing gluten-containing foods may reduce the risk for celiac disease, an autoimmune condition that has several similarities with T1D.
In children at increased genetic risk for T1D, our data suggest that parents should wait to introduce any solid foods until after the 4 month birthday. And when the baby is ready, solid foods should be introduced by the 6 months birthday or soon thereafter, preferably while the mother is still breast-feeding the baby, which may reduce the risk of T1D.
MedicalResearch.com Interview with: Ann M. Sheehy, M.D., M.S.
Division Head, Hospital Medicine
University of Wisconsin Department of Medicine
Ann M. Sheehy, M.D., M.S.
Division Head, Hospital Medicine
University of Wisconsin Department of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Sheehy: There were three main findings of our study.
First, we found that observation in clinical practice is very different from the CMS definition of observation. CMS states that observation should rarely last longer than 48 hours, yet 16.5% of our observation encounters lasted longer than 48 hours. CMS also states that observation care is “well-defined”. We found there were 1141 distinct observation codes for our 4578 observation encounters, indicating that observation care is not well defined.
Second, we found that observation care disproportionately affects the general medicine population, as over half of our observation encounters were on the general medicine services. These patients also had longer length of stay, were older, more likely to be female, were more likely to need discharge to a skilled facility, and were more likely to have government insurance as compared to patients on other services. This indicates that observation care adversely affects the adult general medicine population more than other patients on other types of services.
Finally, we found that observation cost was greater than reimbursement, resulting in a net negative financial margin.
MedicalResearch.com Interview with:Daniel Belsky, PhDNIA Postdoctoral Fellow
Center for the Study of Aging and Human Development
Polygenic risk and the development and course of asthma: an analysis of data from a four-decade longitudinal studyMedicalResearch.com: What are the main findings of the study?Dr. Belsky :We looked to the largest-ever genome-wide association study of asthma (that study by the GABRIEL Consortium included more than 26,000 individuals) to identify genetic variants that could be used to construct a genetic profile of asthma risk. We then turned to The Dunedin Multidisciplinary Health and Development Study, a unique cohort of 1,000 individuals who have been followed from birth through their fourth decade of life with extensive measurements of asthma and related traits. We computed a “genetic risk score” for each person based on the variants identified in GWAS. Then, we looked at who developed asthma, when they developed asthma, and what that asthma looked like in terms of allergic response and impaired lung function.
What we found:
(1) People with higher genetic risk scores were more likely to develop asthma and they developed asthma earlier in life.
(2) Among children who developed asthma, the ones at higher genetic risk were more likely to have persistent asthma through midlife.
(3) Genetic risk was specifically associated with allergic asthma that resulted in chronic symptoms of impaired lung function.
(4) People with higher genetic risk score developed more severe cases of asthma. As compared to people with a lower genetic risk, they were more often absent from school and work because of asthma and they were more likely to be hospitalized for asthma.
(5) The genetic risk score provided new information about asthma risk that could not be obtained from a family history.
MedicalResearch.com Interview with:
Maarten C. Bosland, DVSc, PhD
Professor of Pathology
Department of Pathology
University of Illinois at Chicago
College of Medicine
Chicago, IL 60612
MedicalResearch.com: What are the main findings of the study?Dr. Bosland: Daily consumption of a supplement containing soy protein isolate for two years following radical prostatectomy did not reduce recurrence of prostate cancer in men at high risk for this (radical prostatectomy is surgical removal of the prostate to treat prostate cancer). The study showed that this soy supplementation was safe. It is not clear whether this result indicates that soy does not prevent the development of prostate cancer, but men that have the disease probably do not benefit from soy supplementation.
MedicalResearch.com Interview with:Dr Nazim Ghouri MBChB, MRCP UK
Specialty Registrar (Diabetes/Endocrinology/GIM) and Honorary Clinical Lecturer
Institute of Cardiovascular and Medical Sciences
BHF Glasgow Cardiovascular Research Centre
University of Glasgow
Glasgow G12 8TA
Lower cardiorespiratory fitness contributes to increased insulin resistance and fasting glycaemia in middle-aged South Asian compared with European men living in the UKMedicalResearch.com: What are the main findings of the study?Answer: In this study we aimed to determine the extent to which increased insulin resistance and blood sugar levels in South Asian men, compared to white European men, living in the UK, was due to lower fitness and physical activity levels.
We studied 100 South Asian and 100 European men aged 40-70 years living in Scotland without diagnosed diabetes and measured their blood sugar levels, insulin resistance and other risk factors.
The men also undertook a treadmill exercise test to determine how much oxygen their bodies were able to use during intense exercise – a key measure of physical fitness, wore accelerometers for a week to assess their physical activity levels, and had a detailed assessment of their body size and composition. Statistical modeling was then used to determine the extent to which body size and composition, fitness and physical activity variables explained differences in insulin resistance and blood sugar between South Asians and Europeans.
The results suggested that lower fitness, together with greater body fat in South Asians, explained over 80 per cent of their increased insulin resistance compared to white men with Low fitness being the single most important factor associated with the increased insulin resistance and blood sugar levels in middle-aged South Asian compared to European men living in the UK.
MedicalResearch.com Interview with: Dr David Strain, MRCP MD
Clinical senior lecturer and honorary consultant
University of Exeter Medical School
Institute of Biomedical and Clinical Science
Department of Diabetes and Vascular Research
Royal Devon & Exeter Hospital Exeter EX2 5AX
MedicalResearch.com: What is the Background of the study?
In early 2010 recent diabetes outcome trials such as ACCORD and ADVANCE had put into question the benefit of aggressive HbA1c reduction for all patients particularly in elderly population. After that there were several guidelines that suggested individualizing treatment targets for elderly patients according to their age, co-morbidities, frailty and baseline HbA1c. This featured in the Finnish guidelines and the European Working Party for the management of Diabetes in the Older Person. However this was also completely without any evidence base. I worked with Paivi Paldanius (the final author of the paper and a medical advisor for Novartis) to establish a pragmatic study. We both acknowledged the importance of having a patient-centric, pragmatic and 'real-life' approach and as there was already evidence that DPP-4 inhibitors, in this case vildagliptin (due to Päivi's affiliation), had demonstrated it's efficacious and had no tolerability issues in the elderly population we decided to go ahead with the study.
It was obvious that we needed to implement a holistic approach and take into account as many clinically relevant parameters as possible, such as age, baseline HbA1c, duration of the disease, co-morbidities and frailty, for implementation of the individualized care. Our primary goal was to request that the physicians acting as investigators would still apply their clinical judgment based on these clinical features of each individual patient but also, follow their local guidelines as in their daily clinical practice. This would later provide us with invaluable information and perspective when interpreting the data and recommending implementation of the results. For assessment of frailty we screened for many different methodologies but Prof Timo Strandberg (known expert of the field and mentioned in the acknowledgements section of our paper) suggested to apply modified Linda Fried's method for assessment of phenotype of frailty as this method is validated, very pragmatic, reproducible and also feasible to be used for the first time also by a non-geriatric investigator. All investigators were trained to follow these parameters by the protocol. We also wished to evaluate in parallel the conventional HbA1c drop assessment in order to be able to put the potential success of our new endpoint, meeting the individualized target, into perspective and for comparison against other standard data from other studies with DPP-4 inhibitors with elderly. We also wished to simulate a clinical, real-world setting as much as possible and included patients who would seem representative of most elderly T2DM patients.
MedicalResearch.com Interview with Kenneth Ogan MD
Department of Urology
Emory University School of Medicine
1365 Clifton Rd. NE, Building B, Suite 1400
Atlanta, Georgia 30322
MedicalResearch.com: What are the main findings of the study?
Dr. Ogan: Surgical risk assessment is traditionally a very subjective process, and an evaluation that more accurately measures a patient’s physiologic reserve would greatly aid in surgical decision making. In this study we sought to further characterize frailty as an objective risk assessment tool in surgical patients. We prospectively measured the five component frailty criteria described by Fried et al.1 (weight loss, exhaustion, low activity, grip strength, and gait speed). Patients deemed “intermediately frail” and “frail” had twice the likelihood of experiencing any complication in the 30-day post-operative period.
Dr. Pim A. de Jong,
Department of Radiology
University Medical Center Utrecht,
Heidelberglaan 100, E.01.132, 3508GA
Utrecht, the Netherlands.
MedicalResearch.com: What are the main findings of the study?Dr. de Jong:The main findings of the study is that lung cancer screening CT scans can predict future cardiovascular events.
MedicalResearch.com: Where any of the findings unexpected?Dr. de Jong: The unexpected aspect is that the CT scans were not-ECG gated, but even these non-gated scans were good enough to quantify arterial calcifications and predict risk.
MedicalResearch.com Interview with:
Dr. Lauren A. Wise
Slone Epidemiology Center
1010 Commonwealth Avenue
MedicalResearch.com: What are the main findings of the study?Dr. Wise: We found that the strong inverse association between dairy and uterine fibroids in black women in the Black Women's Health Study is not explained by percent European ancestry.
MedicalResearch.com Interview with: C Raina ElleyAssociate Professor and General Practitioner,
Acting Head, Dept General Practice & Primary Health Care,
Faculty Medical and Health Sciences,
University of Auckland, Private Bag 92019,
Auckland, New Zealand
MedicalResearch.com: What are the main findings of the study?Answer: Type 2 Diabetes is the leading cause of end-stage renal failure and dialysis in many countries. Early identification of those who are at risk within primary care could prompt more intensive intervention to control glycaemia and blood pressure and use of ACE inhibitors or angiotensin receptor blockers to slow progression. Traditionally estimated glomerular filtration rate and/or urine albumin creatinine ratio have been used to alert clinicians of deteriorating renal function in people with diabetes. However, a far more accurate renal risk score has been developed that combines serum creatinine, demographic characteristics, albuminuria, glycaemia, blood pressure, cardiovascular co-morbidity and duration of diabetes.
The 5-year renal risk score was developed by following more than 25,000 people with type 2 diabetes in New Zealand for a median of 7.3 years (equivalent to 180,497 person-years). The study identified those who commenced dialysis for end-stage renal disease, received a renal transplant or died from renal failure to derive the risk score.
MedicalResearch.com Interview with: Keith Summa MD/PhD StudentNorthwestern University Feinberg School of Medicine
Chicago, Illinois, United States of America
Disruption of the Circadian Clock in Mice Increases Intestinal Permeability and Promotes Alcohol-Induced Pathology and InflammationMedicalResearch.com: What are the main findings of the study?Answer: The main findings of the study were that disruption of circadian rhythms, which we achieved using independent genetic and environmental strategies in mice, leads to impaired function of the intestinal epithelial barrier. This loss of epithelial barrier integrity, which has been associated with numerous diseases, results in "gut leakiness," a phenomenon in which endotoxin from gut bacteria can cross the intestinal wall and enter circulation, promoting inflammation. In particular, using in a disease model of gut-derived endotoxemia and inflammation, alcoholic liver disease, we found the circadian disruption interacted with alcohol, leading to increased gut leakiness, inflammation and liver damage.
MedicalResearch.com Interview with: Virender K. Rehan, MD
Los Angeles Biomedical Research
Institute (LA BioMed).
MedicalResearch.com: What are the main findings of the study?Dr. Rehan: This is the first study to show that the active ingredient in Indian spice
turmeric provides long term protection against neonatal lung damage that
leads to chronic lung disease of prematurity.
MedicalResearch.com Interview with Batool Haider, MD, MS, DSc candidate
Departments of Epidemiology and Nutrition
School of Public Health
Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysisMedicalResearch.com: What are the main findings of the study?Dr. Haider: The main findings of the study are that iron use in the prenatal period increased maternal mean haemoglobin concentration by 4.59 (95% confidence interval 3.72 to 5.46) g/L compared with controls and significantly reduced the risk of anaemia (relative risk 0.50, 0.42 to 0.59), iron deficiency (0.59, 0.46 to 0.79), iron deficiency anaemia (0.40, 0.26 to 0.60), and low birth weight (0.81, 0.71 to 0.93). The effect of iron on preterm birth was not significant (relative risk 0.84, 0.68 to 1.03). Analysis of cohort studies showed a significantly higher risk of low birth weight (adjusted odds ratio 1.29, 1.09 to 1.53) and preterm birth (1.21, 1.13 to 1.30) with anaemia in the first or second trimester.
Exposure-response analysis indicated that for every 10 mg increase in iron dose/day, up to 66 mg/day, the relative risk of maternal anaemia was 0.88 (0.84 to 0.92) (P for linear trend<0.001). Birth weight increased by 15.1 (6.0 to 24.2) g (P for linear trend=0.005) and risk of low birth weight decreased by 3% (relative risk 0.97, 0.95 to 0.98) for every 10 mg increase in dose/day (P for linear trend<0.001). Duration of use was not significantly associated with the outcomes after adjustment for dose. Furthermore, for each 1 g/L increase in mean haemoglobin, birth weight increased by 14.0 (6.8 to 21.8) g (P for linear trend=0.002); however, mean haemoglobin was not associated with the risk of low birth weight and preterm birth. No evidence of a significant effect on duration of gestation, small for gestational age births, and birth length was noted.
MedicalResearch.com Interview with: Jonas Eriksson, PhD-student
Clinical Epidemiology Unit
Karolinska Institutet, T2
171 76 STOCKHOLM
Biological vs Conventional Combination Treatment and Work Loss in Early Rheumatoid Arthritis A Randomized TrialMedicalResearch.com: What are the main findings of the study?
Answer: The main finding from this study is that in patients with early rheumatoid arthritis and with an insufficient response to methotrexate, addition of biologic (infliximab) or conventional combination therapy (sulfasalazine+hydroxychlorquine) resulted in significant improvements in work ability over 21 months. However, at 21 months, no significant difference could be detected in work ability change between patients randomized to addition of biologic or conventional therapy. When comparing the randomized early rheumatoid arthritis patients to matched general population comparators, the average number of days of work loss did not return to the level of the general population, underscoring the need for more effective treatment strategies and earlier diagnosis.
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