How to interpret radiological progression in randomized clinical trials?
R. B. M. Landewé, M. Boers1 and D. M. F. M. van der Heijde Department of Internal Medicine/Rheumatology, University Hospital Maastricht and 1 Department of Clinical Epidemiology and Biostatistics, Free University Medical Center, Amsterdam, The Netherlands Radiological progression is a hallmark of rheumatoid arthritis (RA) that can be visualized on plain radiographs. Advantages of this technique include its low cost and wide availability. Standards for measurement and analysis of damage progression are now available and broadly accepted. Disadvantages are that plain radiographs are insensitive for early changes. The acceptance of standards has encouraged the rheumatological community and drug registration authorities to rely on radiological progression as one of the most important outcome parameters by which to judge the efficacy of new disease-modifying anti-rheumatic drugs (DMARDs). Hence, information about which anti-rheumatic drugs retard progression, as well as their rank order, is
