Faculty Bibliography

OBJECTIVE: We had the impression that randomized clinical trials (RCT) frequently over enrolled patients. Thus, we surveyed power calculations in publications of RCTs of biologics in rheumatoid arthritis (RA) to assess over enrollment. METHODS: A PubMed search identified 40 reports of original RCTs testing the efficacy of infliximab, etanercept, adalimumab, abatacept, rituximab and tocilizumab in RA patients. As a first analysis, based on a two equal arms study with an alpha error of 0.05 and a power of 80% and of 90%, recalculation of the sample size was done by using the primary outcome results. In the second analysis, only those studies with equal number of patients in both arms and also in which all elements of a power calculation were given, were considered. New sample sizes were calculated based on the presented power elements in the related publications. RESULTS: In the first analysis when we assigned a power of 80% and of 90%, 32/40 (80%) studies enrolled more than required number of patients, with a mean 131 +/- 147 (SD) and 31/40 (78%) studies having had enrolled extra patients, with a mean 121 +/- 147 (SD) in their treatment arms, respectively. Eleven studies qualified for the second analysis. There were still more patients with a mean of 48 +/- 30 (SD) extra patients enrolled in the treatment arms. CONCLUSION: Most RCTs in RA enroll more patients than needed. This is costly and has the immediate consequence of exposing needless number of patients to potential harm

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Headache, a common and disabling symptom in Behcet's syndrome, may be associated with a variety of neurologic syndromes and ocular inflammation, or may present as an isolated feature. Our objective is to describe the various neurologic and ocular syndromes of Behcet's syndrome of which headache is a symptom, and to review the features of isolated headaches in Behcet's. We also report results of a study of headache in Behcet's syndrome patients who are followed at NYU Hospital for Joint Diseases, the first study of its kind in North American patients, and the first to document prevalence of both episodic and chronic daily headache in Behcet's.