Table 7.21Biochemical markers

StudySequenceOutcomesFollow-upResult – best treatment
MASCOT study255
Level 1++
SSZ then SSZ + MTX vs SSZ continuousESR, CRPChange from 6–18 monthsNS
SSZ then SSZ + MTX vs SSZ then MTXESR (Median difference 1.0)Change from 6–18 monthsArm 1 (p=0.033)
SSZ then MTX vs SSZ continuousESR, CRPChange from 6–18 monthsNS
1 RCT (Ferraccioli et al.)260
Level 1+
DMARD then DMARD + MTX vs DMARD then DMARD + SSZESR (18 months MD 30.2, 36 months MD 5.5); CRP (18 months MD 11.2, 36 months MD 0.9)18 months and 18–36 monthsArm 1 (p=0.01, p=0.001; both p=0.001)
DMARD then DMARD + CsA vs DMARD then DMARD + SSZESR18 months and 18–36 monthsNS
CRP (18–36 months MD 8.1)18 monthsNS
18–36 monthsArm 1 (p=0.03)
TICORA study242
Level 1++
Intensive vs routineESR (MD 18, 95% CI 8 to 28)18 monthsArm 1 (p=0.0007)
1 cohort study (Hider et al.)263
Level 2+
Starting on SSZ vs starting on MTXCRP5 yearsNS

From: 7, Pharmacological management

Cover of Rheumatoid Arthritis
Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults.
NICE Clinical Guidelines, No. 79.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2009, Royal College of Physicians of London.

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