Sustained discontinuation of infliximab with a raising-dose strategy after obtaining remission in patients with rheumatoid arthritis: the RRRR study, a randomised controlled trial.

Objectives: The aim of this study is to determine whether the 'programmed' infliximab (IFX) treatment strategy (for which the dose of IFX was adjusted based on the baseline serum tumour necrosis factor α (TNF-α)) is beneficial to induction of clinical remission after 54 weeks and sustained discontinuation of IFX for 1 year.

Methods: In this multicentre randomised trial, patients with IFX-naïve rheumatoid arthritis with inadequate response to methotrexate were randomised to two groups; patients in programmed treatment group received 3 mg/kg IFX until week 6 and after 14 weeks the dose of IFX was adjusted based on the baseline levels of serum TNF-α until week 54; patients in the standard treatment group received 3 mg/kg of IFX. Patients who achieved a simplified disease activity index (SDAI) ≤3.

Attachment of artificial cartilage to underlying bone.

The key problem with artificial joint materials is obtaining quick and firm attachment onto the underlying bone. In developing artificial articular cartilage, composed of polyvinyl alcohol hydrogel (PVA-H), this problem was solved by using a composite osteo-chondral device (COD). This enables attachment within four weeks post-operation by massive bone ingrowth into the pores.