Biologics for rheumatoid arthritis: an overview of Cochrane reviews.
Jasvinder A. Singh,Robin Christensen,George A. Wells,Maria E. Suarez-Almazor,Rachelle Buchbinder,Maria A. Lopez-Olivo,Elizabeth Tanjong Ghogomu,Peter Tugwell +7 more
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TLDR
Anakinra seemed less efficacious than etanercept, adalimumab and rituximab and etanerscept seemed to cause fewer withdrawals due to adverse events than ad alimumab, anakinra and infliximab, according to indirect comparisons.Abstract:
BACKGROUND the biologic disease-modifying anti-rheumatic drugs (DMARDs) are very effective in treating rheumatoid arthritis (RA), however there is a lack of head-to-head comparison studies. OBJECTIVES to compare the efficacy and safety of abatacept, adalimumab, anakinra, etanercept, infliximab, and rituximab in patients with RA. METHODS this 'Overview of Reviews' was done by including all Cochrane Reviews on Biologics for RA available in The Cochrane Library. We included only data on standard dosing regimens for these biologic DMARDs from placebo-controlled trials. The primary efficacy and safety outcomes were ACR50 and withdrawals due to adverse events. We calculated Risk Ratios (RR) for efficacy, Odds Ratio (OR) for safety and combined estimates of events across the placebo groups as the expected Control Event Rate (CER). Indirect comparisons of biologics were performed for efficacy and safety using a hierarchical linear mixed model incorporating the most important study level characteristic (i.e. type of biologic) as a fixed factor and study as a random factor; reducing the between study heterogeneity by adjusting for the interaction between the proportion of patients responding on placebo and the duration of the trial. MAIN RESULTS from the six available Cochrane reviews, we obtained data from seven studies on abatacept, eight on adalimumab, five on anakinra, four on etanercept, four on infliximab, and three on rituximab. The indirect comparison estimates showed similar efficacy for the primary efficacy outcome for all biologics with three exceptions. Anakinra was less efficacious than etanercept with a ratio of RRs (95% CI; P value) of 0.44 (0.23 to 0.85; P = 0.014); anakinra was less efficacious than rituximab, 0.45 (0.22 to 0.90; P = 0.023); and likewise adalimumab was more efficacious than anakinra, 2.34 (1.32 to 4.13; P = 0.003). In terms of safety, adalimumab was more likely to lead to withdrawals compared to etanercept, with a ratio of ORs of 1.89 (1.18 to 3.04; P = 0.009); anakinra more likely than etanercept, 2.05 (1.27 to 3.29; P = 0.003); and likewise etanercept less likely than infliximab, 0.37 (0.19 to 0.70; P = 0.002). AUTHORS' CONCLUSIONS based upon indirect comparisons, anakinra seemed less efficacious than etanercept, adalimumab and rituximab and etanercept seemed to cause fewer withdrawals due to adverse events than adalimumab, anakinra and infliximab. Significant heterogeneity in characteristics of trial populations imply that these finding must be interpreted.read more
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Journal ArticleDOI
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update
Josef S Smolen,Robert Landewé,Ferdinand C. Breedveld,Maya H Buch,Maya H Buch,Gerd R Burmester,Maxime Dougados,Paul Emery,Paul Emery,Cécile Gaujoux-Viala,Laure Gossec,Jackie L Nam,Jackie L Nam,Sofia Ramiro,Kevin L. Winthrop,Maarten de Wit,Daniel Aletaha,Neil Betteridge,Johannes W. J. Bijlsma,Maarten Boers,Frank Buttgereit,Bernard Combe,Maurizio Cutolo,Nemanja Damjanov,Johanna M. W. Hazes,Marios Kouloumas,Tore K Kvien,Xavier Mariette,Karel Pavelka,Piet L. C. M. van Riel,Andrea Rubbert-Roth,Marieke Scholte-Voshaar,David Scott,T. Sokka-Isler,John B. Wong,Désirée van der Heijde +35 more
TL;DR: These recommendations intend informing rheumatologists, patients, national rheumology societies, hospital officials, social security agencies and regulators about EULAR's most recent consensus on the management of RA, aimed at attaining best outcomes with current therapies.
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs
Josef S Smolen,Robert Landewé,Ferdinand C. Breedveld,Maxime Dougados,Paul Emery,Cécile Gaujoux-Viala,Simone L Gorter,Rachel Knevel,Jackie L Nam,Monika Schoels,Daniel Aletaha,Maya H Buch,Laure Gossec,T.W.J. Huizinga,Johannes W. J. Bijlsma,G.-R. Burmester,B. Combe,Maurizio Cutolo,Cem Gabay,Juan J. Gomez-Reino,Marios Kouloumas,Tore K Kvien,E. Martin-Mola,Iain B. McInnes,Karel Pavelka,P.L.C.M. van Riel,M. Scholte,David Scott,T. Sokka,Guido Valesini,R. van Vollenhoven,Kevin L. Winthrop,John B. Wong,A. Zink,D. van der Heijde +34 more
TL;DR: Recommendations are intended to inform rheumatologists, patients and other stakeholders about a European consensus on the management of RA with DMARDs and GCs as well as strategies to reach optimal outcomes of RA based on evidence and expert opinion.
Journal ArticleDOI
2012 Update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis
Jasvinder A. Singh,Daniel E. Furst,Aseem Bharat,Jeffrey R. Curtis,Arthur Kavanaugh,Joel M. Kremer,Larry W. Moreland,James O'Dell,Kevin L. Winthrop,Timothy Beukelman,S. Louis Bridges,W. Winn Chatham,Harold E. Paulus,Maria E. Suarez-Almazor,Claire Bombardier,Maxime Dougados,Dinesh Khanna,Charles M. King,Amye L. Leong,Eric L. Matteson,John T. Schousboe,Eileen Moynihan,Karen S. Kolba,Archana Jain,Elizabeth R. Volkmann,Harsh Agrawal,Sangmee Bae,Amy S. Mudano,Nivedita M. Patkar,Kenneth G. Saag +29 more
TL;DR: The 2012 ACR RA recommendations were developed by two expert panels: a non-voting working group and Core Expert Panel of clinicians and methodologists responsible for the selection of the relevant topic areas to be considered, the systematic literature review, and the evidence synthesis.
Journal ArticleDOI
EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs
Josef S Smolen,Robert Landewé,Ferdinand C. Breedveld,Maxime Dougados,Paul Emery,Cécile Gaujoux-Viala,Cécile Gaujoux-Viala,Simone L Gorter,Rachel Knevel,Jackie L Nam,Monika Schoels,Daniel Aletaha,Maya H Buch,Laure Gossec,Tom W J Huizinga,Johannes W. J. Bijlsma,Gerd-Rüdiger Burmester,Bernard Combe,Maurizio Cutolo,Cem Gabay,Juan J. Gomez-Reino,Marios Kouloumas,Tore K Kvien,Emilio Martín-Mola,Iain B. McInnes,Karel Pavelka,Piet L. C. M. van Riel,M. Scholte,David Scott,Tuulikki Sokka,Guido Valesini,Ronald F van Vollenhoven,Kevin L. Winthrop,John H. Wong,Angela Zink,Désirée van der Heijde +35 more
TL;DR: In this article, the authors present a set of recommendations for the treatment of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids (GCs) that also account for strategic algorithms and deal with economic aspects.
Journal ArticleDOI
Methodology in conducting a systematic review of systematic reviews of healthcare interventions
TL;DR: Conducting a systematic review of reviews highlights the usefulness of bringing together a summary of reviews in one place, where there is more than one review on an important topic.
References
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Journal ArticleDOI
American College of Rheumatology 2008 Recommendations for the Use of Nonbiologic and Biologic Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis
Kenneth G. Saag,Gim Gee Teng,Nivedita M. Patkar,Jeremy Anuntiyo,Catherine Finney,Jeffrey R. Curtis,Harold E. Paulus,Amy S. Mudano,Maria Pisu,Mary Elkins-Melton,Ryan C. Outman,Jeroan J. Allison,Maria Suarez Almazor,S. Louis Bridges,W. Winn Chatham,Marc C. Hochberg,Catherine H. MacLean,Ted R. Mikuls,Larry W. Moreland,James O'Dell,Anthony M. Turkiewicz,Daniel E. Furst +21 more
TL;DR: Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient.
Reference EntryDOI
Biologics for rheumatoid arthritis: an overview of Cochrane reviews
Jasvinder A. Singh,Robin Christensen,George A. Wells,Maria E. Suarez-Almazor,Rachelle Buchbinder,Maria A. Lopez-Olivo,Elizabeth Tanjong Ghogomu,Peter Tugwell +7 more
TL;DR: Anakinra seemed less efficacious than etanercept, adalimumab and rituximab and etanerscept and seemed to cause fewer withdrawals due to adverse events than ad alimumab, anakinra and infliximab, however there is a lack of head-to-head comparison studies.
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EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs
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