Top 100 Studies on Rheumatoid Arthritis

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Peer-reviewed publications about rheumatoid arthritis have been on the rise for the last 30 years.

As the body of literature around rheumatoid arthritis has grown, the most details have emerged about its pathogenesis, diagnosis, and treatment. A recent study published in Medicine highlights the top 100 articles focused on rheumatoid arthritis that have revealed the most data.

Investigators analyzed studies, published from 1985 to Dec. 31, 2017, in Web of Science, a database with articles from nearly 9,000 journals. The site also provides citation index searching, a function that helps evaluate academic importance. Two reviewers independently screened the abstracts and full texts to identify the top 100 most cited rheumatoid arthritis articles.

“By analyzing contents of clinical studies in the past three decades, we found that the diagnosis and treatment of early rheumatoid arthritis was gradually gaining importance in the rheumatoid field,” investigators said.

These articles show a progression of how rheumatoid arthritis has been diagnosed. There is no single test or criteria that confirms the diagnosis, but these publications show updates in the diagnostic criteria every few years with the goal of earlier disease identification, the researchers said.

Overall, the top 100 articles were published in 24 journals. The most common was Arthritis & Rheumatism (n=33), totaling 44,765 citations. An additional 37 percent of articles were published in other high-impact journals. As expected, studies published in those high-impact journals were cited most frequently.

The top 100 (T100) articles were divided into several categories: clinical study, review, meta-analysis, clinical guidelines, and basic science. Clinical studies accounted for most of the articles (n=55), focusing mainly on identifying the effectiveness or safety of a drug therapy. Randomized controlled trials were the most common (n=32), followed by prospective-cohort studies, case-controlled studies, case series, retrospective-cohort studies, and cross-sectional studies.

The content of these articles also fell into several categories, including classification criteria, evaluation of drug therapy, disease activity evaluation, pathogenesis, risk factor, and description of epidemiology. Studies on the evaluation of drug therapy appeared the most (n=48), and they provided an analysis of drug treatment strategy effectiveness and the risks of other diseases post-treatment.

Articles focused on clinical guidelines revealed rheumatoid arthritis classification criteria, management recommendations with different drug types, advice on evaluating disease activity pre- and post-treatment, and cardiovascular risk management. These studies, which provided guidance for proper diagnosis and treatment, also explored other risk factors, such as genetic factors (IL2RA, CCL21, and AFF3).

The review did have some limitations, investigators said. The analysis was limited to articles pulled from Web of Science, and no studies published in non-English languages were included. In addition, self-citations were not taken into consideration.

Although this article examines the growth of rheumatoid arthritis publications over the past 30 years, researchers said, it likely does not cite all of the most influential articles.

“The latest publications may not be included in the T100 articles, as the more recent studies have not had sufficient time to accumulate the number of citations,” they said.

TOP 20 STUDIES

1. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis
2. Modified disease activity scores that include 28-joint counts development and validation in a prospective longitudinal study of patients with rheumatoid arthritis
3. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patietns with rheumatoid arthritis
4. Infliximab and methotrexate in the treatment of rheumatoid arthritis
5. Gastrointestinal toxicity with celecoxib vs. nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis The class study: A randomized controlled trial
6. 2010 rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative
7. American College of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis
8. Role of cytokines in rheumatoid arthritis
9. Evolving concepts of rheumatoid arthritis
10. Infliximab (chimeric anti-tumor necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: A randomized phase III trial
11. The shared epitope hypothesis: An approach to understanding the molecule-genetics of susceptibility to rheumatoid arthritis
12. Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis
13. A trial of etanercept, a recombinant tumor necrosis factor receptor: Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate
14. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infection and malignancies: Systemic review and meta-analysis of rare harmful effects in randomized controlled trials
15. Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor alpha (cA2) versus placebo in rheumatoid arthritis
16. Rheumatoid arthritis: Pathophysiology and implications for therapy
17. The pathogenesis of rheumatoid arthritis
18. A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis
19. Mechanisms of disease: Cytokines pathways and joint inflammations in rheumatoid arthritis
20. Treatment of rheumatoid arthritis with a recombinant human tumor necrosis factor receptor (p75)-Fc fusion proteinTOP CITED JOURNALS

1. Arthritis & Rheumatism (n=33)
2. New England Journal of Medicine (n=15)
3. Lancet (n=12)
4. Annals of the Rheumatic Diseases (n=7)
5. Nature (n=4)

REFERENCE

Yin X, Cheng F, Wang X, Mu J, Ma C, Zhai C, Wang Q, Top 100 cited articles on rheumatoid arthritis. Medicine (2019), http://dx.doi.org/10.1097/MD.0000000000014523