Response to commentary by Dixon and Silman on the systematic review and meta-analysis by Bongartz et al. 英文参考文献.docVIP

Available online /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 1Division 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@ Published: 1 September 2006 Arthritis Research Therapy 2006, 8:404 (doi:10.1186/ar2033) This article is online at /content/8/5/404 ? 2006 BioMed Central Ltd See related commentary by Dixon and Silman, /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]. many as 61% of patients with rheumatoid arthritis after 1 year of use receive, on average, 4.9 mg/kg of infliximab [3]. The manufacturer’s product label for infliximab allows doses up to 10 mg/kg of infliximab for partial responders [4]. Thus, not only are our findings applicable to clinical practice and biologically plausible, but they also fulfill the dose-effect criterion for causality. 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. The low risk in the comparison group may be real, the result of chance, or due to an as yet unclear systematic design or analysis flaw of al