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Objectives To compare radiographic progression during treatment with disease-modifying antirheumatic drugs (DMARD) and subsequent treatment with tumour necrosis factor α inhibitors (TNF-I) in rheumatoid arthritis (RA) patients in clinical practice. Methods Conventional radiographs (x-rays) of hands and wrists were obtained ~2 years before start (prebaseline), at baseline and ~2 years after start (follow-up) of TNF-I. Clinical data were obtained from the DANBIO registry and the patient fi les. x-Rays were scored blinded to chronology according to the Sharp/van der Heijde method. Annual radiographic progression rates during the DMARD (prebaseline to baseline x-ray) and TNF-I (baseline to follow-up x-ray) periods were calculated. Results 517 RA patients (76% women, 80% IgM rheumatoid factor positive, 65% anticyclic citrullinated peptide positive, 40% current smokers, age 54 years (range 21-86), median disease duration 5 years (range 0-57)) were included. Patients were treated with infl iximab (61%), etanercept (15%) or adalimumab (24%). During the DMARD period 85% of patients received methotrexate, 51% sulphasalazine and 78% prednisolone. The median DMARD period was 733 days (IQR 484- 1002) and the median TNF-I period was 562 days (IQR 405-766). The median radiographic progression rate decreased from 0.7 (IQR 0-2.9) total Sharp score units/ year (dTSS) in the DMARD period to 0 (0-0.9) units/year in the TNF-I period (p<0.0001, Wilcoxon). Corresponding mean dTSS values were 2.1 (SD 3.7) versus 0.7 (SD 2.3) units/year (p<0.0001, paired t test). 305 patients progressed (dTSS >0) in the DMARD period compared with 158 patients in the TNF-I period (p<0.0001, x²). Conclusion This nationwide observational study of RA patients documented signifi cantly reduced radiographic progression during TNF-I treatment compared with the previous period of DMARD treatment. [ABSTRACT FROM AUTHOR]

Examines the influence of oral magnesium supplementation on cardiac events among survivors of an acute myocardial infarction in Copenhagen, Denmark. Intravenous infusion of magnesium in acute myocardial infarction; Evaluation of the bioavailability of magnesium hydroxide; Comparison between intravenous and oral magnesium treatment. INSET: Clinical implications.

A letter to the editor in response to the article related to effect of sodium intake on blood pressure in the previous issue and a response from the author on same is presented.

A letter to the editor is presented in response to the article "Effect of lower sodium intake on health: systematic review and meta-analyses" by N.J. Aburto and colleagues in the April 4, 2013 issue.