Risk of bias for analysis 3.1 Disease‐specific mortality.

Study

Bias

Randomisation process

Deviations from intended interventions

Missing outcome data

Measurement of the outcome

Selection of the reported results

Overall

Authors' judgement

Support for judgement

Authors' judgement

Support for judgement

Authors' judgement

Support for judgement

Authors' judgement

Support for judgement

Authors' judgement

Support for judgement

Authors' judgement

Support for judgement

Wang 2018

Low risk of bias

‐allocation sequence was random and concealed: “a random number was generated by the clinical trial center... after which the investigator was given the random number and initiated the appropriate treatment” ‐no baseline differences between intervention groups to suggest problem with randomization process

Low risk of bias

Participants could not be blinded. Quote: "Because the injection methods are quite different for etanercept and corticosteroids, this was not a blinded clinical trial." Carers do not seem to have been blinded. Quote: "investigator was given the random number and initiated the appropriate treatment" Nothing to suggest deviations from the intended intervention because of the trial context. All participants analysed according to the group they were assigned to.

Low risk of bias

‐Full data reported for all participants

Low risk of bias

‐The outcomes were collected from this study are felt to be objective measures, and measurement unlikely to have differed between groups despite a lack of blinding of outcome assessors

Some concerns

‐Mortality was not specified as an outcome in the trial registry record

Some concerns

The study is judged to raise some concerns in at least one domain for this result, but not to be at high risk of bias for any domain.