Extraarticular Manifestations of Rheumatoid Arthritis in Patients under Anti-tumor Necrosis Factor-α Treatment
Bibliographic record
Abstract
To the Editor: We read with great interest the article on extraarticular manifestations of rheumatoid arthritis (RA) developing in patients under anti-tumor necrosis factor-α (TNF-α) treatment by Negoescu, et al 1. These manifestations were present in 42/152 patients (27.6%), of whom 22/152 (14.5%) were newly diagnosed and 5/152 (3.3%) were worsened preexisting manifestations of lung disease, subcutaneous rheumatoid nodules, and cutaneous vasculitis. One patient had stable chronic renal failure of unclear cause. Conversely, regression of cutaneous nodules was observed in 4 patients, and some patients were in disease remission while others had active disease. This paper raises serious concern for physicians prescribing these biotherapeutic agents, and its results require clarification. First, with regard to the lung lesions, a wide variety of lung diseases have been described in patients with RA including interstitial lung disease (ILD) and rheumatoid nodules, but also pleural disease, Caplan syndrome, and bronchiectasia2. What were the features of lung lesions in patients in … Address correspondence to Dr. C. Bachmeyer, Department of Internal Medicine, Tenon Hospital (AP-HP), 4 rue de la Chine, 75020 Paris, France. E-mail: claude.bachmeyer{at}tnn.aphp.fr
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.012 | 0.009 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".