Overview of placebo-controlled trials comparing early versus delayed DMARD initiation in patients with arthralgia considered at risk for progression to RA in order to prevent arthritis development
| First author, year of publication | Type of trial | Quality score* | Patients | N | Follow-up time | Intervention | Control | Outcome of interest | Relevant result | Association between early DMARD intervention and outcome |
| Bos, 201084 | Randomised, double-blind placebo-controlled trial. | 93% | ACPA-positive and/or RF-positive patients with arthralgia, without arthritis. SE-positive. | 83 (42/41) | Median 26 months. | 100 mg dexamethasone intramuscularly at 0 and 6 weeks. | 100 mg placebo intramuscularly at 0 and 6 weeks. | Arthritis development. | After a median follow-up of 26 months, 9/42 patients in intervention arm and 8/41 in placebo arm developed arthritis (p=0.9). | NS |
Only full-text articles were reviewed.
*A study with a quality score ≥75% was considered of high quality.
ACPA, anticitrullinated protein antibody;DMARD, disease-modifying antirheumatic drug;NS, not significantRA, rheumatoid arthritis;RF, rheumatoid factor;SE, shared epitope.