Open Access Study protocol

Design characteristics of the CORRONA CERTAIN study: a comparative effectiveness study of biologic agents for rheumatoid arthritis patients

Dimitrios A Pappas12, Joel M Kremer3, George Reed24, Jeffrey D Greenberg25 and Jeffrey R Curtis6*

Author Affiliations

1 Columbia University College of Physicians and Surgeons, New York, NY, USA

2 Consortium of Rheumatology Researchers of North America (CORRONA), Southborough, MA, USA

3 Department of Medicine, Albany Medical Center & The Center for Rheumatology, Albany, NY, USA

4 University of Massachusetts, Worcester, MA, USA

5 New York School of Medicine, New York, NY, USA

6 Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL 35294-7201, USA

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BMC Musculoskeletal Disorders 2014, 15:113  doi:10.1186/1471-2474-15-113

Published: 1 April 2014



Comparative effectiveness research has recently attracted considerable attention. The Comparative Effectiveness Registry to study Therapies for Arthritis and Inflammatory Conditions (CERTAIN) is an ongoing prospective cohort study of adult patients with Rheumatoid Arthritis (RA).


CERTAIN uses the existing Consortium of Rheumatology Researchers of North America (CORRONA) network of participating private and academic sites in order to recruit patients fulfilling the 1987 ACR criteria that have at least moderate disease activity. Patients starting or switching biologic agents either anti-TNF therapy or a non anti-TNF biologic are eligible for enrollment, depending on the treatment selected by their physician. Enrollment is expected to be completed by March of 2014, and 2711 patients will participate in the study. As of October 7th 2013, 2234 patients have been enrolled. Patient visits and laboratory blood work are mandated every three months for one year. Safety data is collected through one year and beyond. The primary comparative effectiveness endpoint is attainment of low RA disease activity at one year among patients who have been exposed to at least one prior TNF-α inhibitor agent prior to enrollment. Multiple secondary effectiveness and safety endpoints will be addressed by investigating the entire population enrolled (naïve and biologic experienced).


The unique design features of CERTAIN will inform comparative effectiveness and safety questions for choosing biologic agents for the management of RA.

Rheumatoid arthritis; Registry; Cohort; Epidemiology; Comparative effectiveness; Safety; Biologics