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Improvements were maintained over longer-term treatment.
The MERIT data reported in this study also demonstrated that the greater CD4+ cell increases seen in MVC-treated patients compared with EFV-treated patients at weeks 48 and 96 were maintained over longer-term follow-up out to 240 weeks, and were, therefore, unlikely to be due to short-term cell redistribution.
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Whereas sperm/oviduct formation is known to occur in the first year of life and has been disrupted in experimental exposures up to 1 year (Environment Agency 2004b), to date it has not been possible to maintain natural environmental conditions over longer-term experimental studies.
There are also indications of skill decay over time, however, with several studies demonstrating that all short-term improvements in knowledge, skills and practices were not maintained over longer time periods.
Over longer-term treatment, the improvements were either maintained or continued at an attenuated rate (Fig. 2).
"The number of new homes under construction has started to pick up, albeit from historically low levels, and further increases are required if a sustainable recovery in the housing market is to be maintained over the longer term".
This study will also determine whether effects of acupuncture can be maintained over the longer term, and whether psychosocial factors influence treatment outcomes.
The TIMER and AFFIRM studies were also relatively short term, and further data are needed to determine whether the beneficial effects observed with natalizumab would be maintained over the longer term.
Patients were to be followed even if treatment was stopped or altered to minimise "dropout bias" and to test the ScHARR model assumptions that benefit up to that point is maintained over the longer term.
Given that we anticipate a difference in risk factors, particularly HbA1c, between the intervention and control arms and that these risk factor differences can potentially be maintained over the longer term, there is a strong economic hypothesis that the upfront investment in the education programme will pay off in terms of avoided clinical events over the longer term.
Future controlled trials need to explore the issue whether pre-existing medication has a significant impact on treatment outcome and also to address the question of whether treatment effects are maintained over the longer term to an equivalent extent for CBT alone, pharmacotherapy alone, or a combined approach.
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