Table 1

Assessment of general study quality and DFR quality, resulting in final categorization as high, moderate or low-quality study

Clinical trialsObservational studies
BeStIMPROVEDAVERTtREACHU-ACT-earlyACT-RAYEl Miedany et alPRIZERETROTen Wolde et alSUPRISEBrocq et alKita et alDREAM trialLeiden EACDREAM cohortTiippanna-Kinnunen et alESPOIRERAS
DMARD-free remissionDFR definition (description of DFR criteria)++++++--------++-++
DFR duration (description of DFR period)+++++-+----++-++-++
Study populationSelection of patients (description inclusion/exclusion criteria)+++++++++++++++++++
Criteria for RA diagnosis++-++++++++++++-+++
Baseline characteristics (description of characteristics)+++++++++++++++++++
Randomisation for different study treatments+++++++++++---n.a.
Blinding of study treatment±±+±++-+-+----n.a.
InterventionTreatment strategies (description of strategies)+++++++++++++++++-+
Cut-off point tapering (description of cut-off point)++++++++++++++-+---
Tapering method (description of methods)++++++++++-+-------
Follow-upOrganisation follow-up (frequency of monitoring)++++++++++++-++++--
Lost to follow up (description of LTFU)++++++???-+++--++++
Data analysis and presentationOutcome reporting++++++++++++++++-?+
Analysis techniques (description of techniques)+++++++++++--++++??
Missing data (handling of missing data)++??+?-±????-?+????
General study quality
  • Studies were assessed for quality of DMARD-free remission: that is, whether definition (yes ‘+’ or no “–”) and duration of drug-free state were reported (yes ‘+’ or no “–”). DFR quality was considered good (“”) when both items were scored as ‘+’, and moderate (‘±’) when only one of two was scored as good. Subsequently, studies were assessed on general study quality. Criteria for general study quality could be scored: ‘+’ indicating sufficient, “-” indicating not sufficient, ‘±’ indicating moderate, ‘?’ indicating unclear reporting and quality could not be assessed. Study quality was considered good (“”) when minimally 75% (10 items) were scored as ‘+’. DFR, DMARD-free remission; DMARD, disease-modifying anti-rheumatic drug; LTFU, lost to follow-up; n.a., not applicable; RA, rheumatoid arthritis. The combined study-quality was considered high (‘HQ’) when both DFR quality and study quality were good. It was considered moderate (‘MQ’) when DFR quality was moderate, and study quality was good. Low (‘LQ’) indicates studies with either insufficient DFR quality or study quality.