Is a 12-week trial sufficient to evaluate clinical responses to etanercept or MTX treatment in early RA?
Bibliographic record
Abstract
Sir, Treatment of RA during the early phase of disease appears to produce better control than treatment that is delayed until disease is more advanced [1–4]. Although clinical response to TNF inhibitors or MTX often occurs within the first days or weeks of treatment [5], some RA patients have a more delayed response to these agents [6]. Because decisions to continue or change therapies may be made at 12 weeks (as described in the TICORA [7] and BeSt [8] trials), it is unknown whether, and to what extent, some patients would respond if allowed to continue for a longer period of treatment. This question is particularly relevant since high-level responses, such as ACR50 and ACR70, may take up to 24–30 weeks to peak. To determine whether more patients would respond during a treatment trial longer than 12 weeks, we evaluated ACR20, ACR50 and ACR70 responses and disease activity scores using 28 joints (DAS-28) at Week 26 in patients with early RA (ERA) who did not respond to etanercept or MTX monotherapy after 12 weeks of treatment. This analysis focuses specifically on patients with ERA; its design is similar to a study of data from the recent trial of etanercept and methotrexate with radiographic patient outcomes (TEMPO) trial of a more heterogeneous RA population [6].
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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 | 0.026 | 0.083 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.033 | 0.015 |
| Insufficient payload (model declined to judge) | 0.005 | 0.005 |
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".