Efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis

Introduction Biologics and traditional disease-modifying anti-rheumatic drugs (DMARDs) are generally used in treating patients with rheumatoid arthritis (RA). Previous studies have presented abundant data and information about the efficacy of such treatments, but the results were incomplete and inco...

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Autores principales:	Kexun Ma, Ling Li, Chunhui Liu, Lingling Zhou, Xueping Zhou
Formato:	article
Lenguaje:	EN
Publicado:	Termedia Publishing House 2018
Materias:	rheumatoid arthritis biologics network meta-analysis disease-modifying anti-rheumatic drugs Medicine R
Acceso en línea:	https://doaj.org/article/309120ba715e4a2a9f1c6560f32803fd
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spelling	oai:doaj.org-article:309120ba715e4a2a9f1c6560f32803fd2021-12-02T19:15:49ZEfficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis1734-19221896-915110.5114/aoms.2018.73714https://doaj.org/article/309120ba715e4a2a9f1c6560f32803fd2018-12-01T00:00:00Zhttps://www.archivesofmedicalscience.com/Efficacy-and-safety-of-various-anti-rheumatic-treatments-for-patients-with-rheumatoid,69683,0,2.htmlhttps://doaj.org/toc/1734-1922https://doaj.org/toc/1896-9151Introduction Biologics and traditional disease-modifying anti-rheumatic drugs (DMARDs) are generally used in treating patients with rheumatoid arthritis (RA). Previous studies have presented abundant data and information about the efficacy of such treatments, but the results were incomplete and inconclusive. This network meta-analysis was conducted to compare and assess the efficacy and safety of 15 therapies employing biologics and DMARDs for RA patients. Material and methods Six outcomes (American College of Rheumatology 20% response rate (ACR20), ACR50, ACR70, remission, adverse events (AEs) and serious adverse events (SAEs)) were used to evaluate the efficacy and safety of different treatments. The node-splitting method was used to assess the inconsistency, and the rank probabilities of the therapies were estimated by surface under the cumulative ranking curve. Besides, Jadad scale was used to evaluate the methodological quality of eligible studies. Results A total of 67 randomized controlled trials with 20,898 patients met the inclusion criteria. Most of the therapies presented better performance than conventional DMARDs (cDMARDs) and placebo in ACR20, ACR50 and ACR70. Conversely, the safety of cDMARDs and placebo seemed to be superior in AEs and SAEs. Also, tocilizumab (TCZ) and TCZ + methotrexate (MTX) showed better remission in pain compared to other treatments. Overall, certolizumab pegol (CZP) + MTX and TCZ + MTX had higher probability than the other treatments in efficacy outcomes. Conclusions We recommend CZP + MTX as the optimal drug therapy because it has the highest ranking in efficacy outcomes and relatively low risk of adverse events. TCZ + MTX is recommended as an alternative. Abatacept (ABT) and cDMARDs are not recommended due to their low efficacy.Kexun MaLing LiChunhui LiuLingling ZhouXueping ZhouTermedia Publishing Housearticlerheumatoid arthritisbiologicsnetwork meta-analysisdisease-modifying anti-rheumatic drugsMedicineRENArchives of Medical Science, Vol 15, Iss 1, Pp 33-54 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	rheumatoid arthritis biologics network meta-analysis disease-modifying anti-rheumatic drugs Medicine R
spellingShingle	rheumatoid arthritis biologics network meta-analysis disease-modifying anti-rheumatic drugs Medicine R Kexun Ma Ling Li Chunhui Liu Lingling Zhou Xueping Zhou Efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis
description	Introduction Biologics and traditional disease-modifying anti-rheumatic drugs (DMARDs) are generally used in treating patients with rheumatoid arthritis (RA). Previous studies have presented abundant data and information about the efficacy of such treatments, but the results were incomplete and inconclusive. This network meta-analysis was conducted to compare and assess the efficacy and safety of 15 therapies employing biologics and DMARDs for RA patients. Material and methods Six outcomes (American College of Rheumatology 20% response rate (ACR20), ACR50, ACR70, remission, adverse events (AEs) and serious adverse events (SAEs)) were used to evaluate the efficacy and safety of different treatments. The node-splitting method was used to assess the inconsistency, and the rank probabilities of the therapies were estimated by surface under the cumulative ranking curve. Besides, Jadad scale was used to evaluate the methodological quality of eligible studies. Results A total of 67 randomized controlled trials with 20,898 patients met the inclusion criteria. Most of the therapies presented better performance than conventional DMARDs (cDMARDs) and placebo in ACR20, ACR50 and ACR70. Conversely, the safety of cDMARDs and placebo seemed to be superior in AEs and SAEs. Also, tocilizumab (TCZ) and TCZ + methotrexate (MTX) showed better remission in pain compared to other treatments. Overall, certolizumab pegol (CZP) + MTX and TCZ + MTX had higher probability than the other treatments in efficacy outcomes. Conclusions We recommend CZP + MTX as the optimal drug therapy because it has the highest ranking in efficacy outcomes and relatively low risk of adverse events. TCZ + MTX is recommended as an alternative. Abatacept (ABT) and cDMARDs are not recommended due to their low efficacy.
format	article
author	Kexun Ma Ling Li Chunhui Liu Lingling Zhou Xueping Zhou
author_facet	Kexun Ma Ling Li Chunhui Liu Lingling Zhou Xueping Zhou
author_sort	Kexun Ma
title	Efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis
title_short	Efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis
title_full	Efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis
title_fullStr	Efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis
title_full_unstemmed	Efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis
title_sort	efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis
publisher	Termedia Publishing House
publishDate	2018
url	https://doaj.org/article/309120ba715e4a2a9f1c6560f32803fd
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Efficacy and safety of various anti-rheumatic treatments for patients with rheumatoid arthritis: a network meta-analysis

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