Drug Therapy for Rheumatoid Arthritis in Adults
Comparisons of Biologic DMARDs Across Controlled Studies: Mixed Treatment Comparisons
The authors of the comparative effectiveness review used data from placebo-controlled trials to compare biologic disease-modifying anti-rheumatic drugs (DMARDs) across studies, using an analytic method called a “mixed treatment comparison.” The patient populations in the studies had methotrexate-resistant rheumatoid arthritis. The outcome analyzed was the rate of achieving the American College of Rheumatology 50-percent response criteria (ACR50). Thirty placebo controlled trials with a total of 6,888 patients included the biologic DMARDs abatacept, adalimumab, anakinra, etanercept, golimumab, infliximab, rituximab, and tocilizumab. The analysis demonstrated that etanercept yields the greatest ACR50 response when compared with other biologics and that anakinra yields the lowest. However, the strength of evidence is low, as the comparisons are indirect.
Keywords: Rheumatoid arthritis | RA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | biologic DMARD | disease activity | symptom response | methotrexate | abatacept | adalimumab | anakinra | etanercept | golimumab | infliximab | rituximab | and tocilizumab
- 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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