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Báo cáo y học: "Response to commentary by Dixon and Silman on the systematic review and meta-analysis by Bongartz et al"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Response to commentary by Dixon and Silman on the systematic review and meta-analysis by Bongartz et al. | Available online http arthritis-research.eom content 8 5 404 Letter Response to commentary by Dixon and Silman on the systematic review and meta-analysis by Bongartz et al. Eric L Matteson1 Tim Bongartz1 Alex J Sutton2 and Iain Buchan3 1 Division of Rheumatology Mayo Clinic College of Medicine Rochester Minnesota USA 2Department of Health Sciences University of Leicester Leicester UK 3Northwest Institute for Bio-Health Informatics University of Manchester Manchester UK Corresponding author Eric L Matteson matteson.eric@mayo.edu Published 1 September 2006 Arthritis Research Therapy 2006 8 404 doi 10.1186 ar2033 This article is online at http arthritis-research.com content 8 5 404 2006 BioMed Central Ltd See related commentary by Dixon and Silman http arthritis-research.com content 8 5 111 Dixon and Silman 1 provide an insightful review of the methodology and results of our meta-analysis of harmful events among patients with rheumatoid arthritis treated with anti-tumour necrosis factor TNF antibody agents 2 . Meta-analyses of valid randomized trials of like agents ensure that in the absence of a treatment effect patients with rheumatoid arthritis in the intervention and placebo groups should share the same risk for developing serious infections or malignancy. Etanercept although it needs study was not included in our analysis because it is dissimilar from the anti-TNF agents. A particular advantage of such trials is that there is almost complete follow up of each treatment arm with patients maintained in the assigned groups for intent-to-treat analysis at least for the randomized portion of the trial even if drug exposure is discontinued for whatever reason. The appropriate statistical analysis of such comparator groups in the trial context of equivalent follow up in each arm is an odds ratio rather than incidence rate ratio. Dixon and Silman raise the possibility of bias in our analysis because of the greater dropout rate in the placebo arm potentially leading to a