Drug Therapy for Rheumatoid Arthritis in Adults
Summary of Results: Head-to-Head Comparisons of Oral and Biologic DMARDs
The reviewed studies included direct comparisons of oral and biologic disease-modifying anti-rheumatic drugs (DMARDs) used to treat patients with longstanding active rheumatoid arthritis who required a change in therapy. A retrospective cohort study of 1,083 patients found that as a class, biologic DMARDs resulted in more remissions when compared with oral DMARDs as a class. The systematic review found that biologic DMARDs achieved a higher response rate than oral DMARDs. The strength of evidence for this finding is moderate.
Four randomized controlled trials and two retrospective cohort studies evaluated 3,696 patients in comparisons of biologic DMARDs with oral DMARDs. Higher symptom response rates were found with biologic DMARDs. The strength of the evidence for this conclusion is moderate.
Radiographic evidence of progression was not reported in the studies presented here, and evidence for findings of effect on functional capacity was insufficient to permit conclusions.
Keywords: rheumatoid arthritis | RA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | biologic DMARD | disease activity | symptom response | quality of life | methotrexate
- Donahue KE, Jonas D, Hansen RA, et al. Drug Therapy for Rheumatoid Arthritis in Adults: An Update. Comparative Effectiveness Review No. 55 (Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2007-10056-I). Rockville, MD: Agency for Healthcare Research and Quality; April 2012. AHRQ Publication No. 12-EHC025-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsra.cfm.
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