Component network meta‐analysis compared to a matching method in a disconnected network: A case study

Rücker, Gerta; Schmitz, Susanne; Schwarzer, Guido

doi:10.1002/bimj.201900339

Cited by 31 publications

(57 citation statements)

References 23 publications

(49 reference statements)

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“…Although Upadacitinib 30 mg daily has been considered the most effective drug in achieving EASI75, the OR when compared to placebo is 18.9 in monotherapy, and slightly higher than 9 in combination with TCS. Although there are statistical techniques that allow estimating the effect of each treatment in combined RCT arms [ 41 ], they require some link in the NMA networks that does not exist at present between RCTs of AD in adults. Indeed, we have two isolated NMA networks, one where exclusively monotherapy drugs studies are analyzed, and the other one where both the active drug and the comparator arms are associated with TCS, so it is not possible to apply these techniques.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Effectiveness and Safety of Biologics and Small Molecule Drugs for Moderate to Severe Atopic Dermatitis: A Systematic Review and Network Meta-Analysis

Pereyra‐Rodriguez

Alcantara-Luna

Domínguez-Cruz

et al. 2021

Life

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Background: Some Network Meta-analysis (NMA) has been published regarding atopic dermatitis (AD). These studies have considered drugs under investigation both in monotheraphy or in combination with topical corticosteroids, as well as systemic immunosuppressant therapies. The objective of this study is to evaluate the efficacy and safety of biological agents and small molecules in AD. Methods: A systematic review and NMA of biologics agents and small molecules in AD was performed. A literature search was performed using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for clinical trials and systematic reviews between January 2000 and 19 December 2020. Only randomized clinical trials (RCTs) were included. It was limited to English language and adult human subjects. Two networks were evaluated: monotherapy and combination with TCS. The two primary outcomes were Eczema Area and Severity Index (EASI) 75 and EASI 90 change from baseline to week 12–16, depending on source study cut-off. The Cochrane’s Risk of Bias tool 2011 update was used to analyze the risk of bias, focused on the primary objectives. Results: 30 RCTs (included in 26 publications) were included in the systematic review. Finally, 23 RCTs were included in the quantitative analysis (14 RCTs including 3582 patients in monotherapy; and 9 RCTs including 3686 patients with TCS). In monotherapy, a higher percentage of patients achieving EASI-75 was obtained with Upadacitinib 30 mg [OR: 18.90 (13.94; 25.62)] followed by Abrocitinib 200 mg [OR = 11.26 (7.02; 18.05)] and Upadacitinib 15 mg [OR: 10.89 (8.13; 14.59)]. These results were also observed in studies where the use of topical corticosteroid (TCS) was allowed (OR Upadacitinib 30 mg = 9.43; OR Abrocitinib 200 mg = 6.12; OR Upadacitinib 15 mg = 5.20). Regarding IGA, the percentage of patients achieving IGA0/1 was higher with both doses of Upadacitinib 30 mg [OR: 19.13 (13.14; 27.85)] and 15 mg [OR = 10.95 (7.52; 15.94). In studies where the use of TCS were allowed, however, the dose of Abrocitinib 200 mg [OR = 6.10 (3.94; 9.44)] showed higher efficacy than Upadacitinib 15 mg [OR = 5.47 (3.57; 8.41)]. Regarding safety, the drugs with the highest probability of presenting adverse effects were the Janus kinases (JAK) inhibitors, Upadacitinib and Abrocitinib in monotherapy and Baricitinib in combination with TCS. Discussion: Some risks of bias have been found, which must be taken into account when interpreting the results. The funnel plot shows a possible publication bias that may underestimate the efficacy of drugs. Upadacitinib and Abrocitinib are the drugs with the highest efficacy, both in monotherapy and in association with TCS. However, they were also those associated with the highest risk of adverse effects, showing monoclonal antibodies better safety profile. Limitations: We have included molecules still in the development phase as well studies completed and presented at conferences and with data available in Trialsgov® but not published yet. Several molecules’ development had included a small number of patients from 12 to 17 years of age, without being able to differentiate the results from the adult population. Other: Founding: None. PROSPERO database registration number CRD42021225793.

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Section: Discussionmentioning

confidence: 99%

Short-Term Effectiveness and Safety of Biologics and Small Molecule Drugs for Moderate to Severe Atopic Dermatitis: A Systematic Review and Network Meta-Analysis

Pereyra‐Rodriguez

Alcantara-Luna

Domínguez-Cruz

et al. 2021

Life

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“…Interaction terms should be defined a-priori [ 35 , 56 ]. A currently developed method for model selection on CNMA models can be used on top of this prespecification to decide which interactions to include in the CNMA model and therefore which CNMA model fits best [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

A review of methods for addressing components of interventions in meta-analysis

et al. 2021

Self Cite

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Many healthcare interventions are complex, consisting of multiple, possibly interacting, components. Several methodological articles addressing complex interventions in the meta-analytical context have been published. We hereby provide an overview of methods used to evaluate the effects of complex interventions with meta-analytical models. We summarized the methodology, highlighted new developments, and described the benefits, drawbacks, and potential challenges of each identified method. We expect meta-analytical methods focusing on components of several multicomponent interventions to become increasingly popular due to recently developed, easy-to-use, software tools that can be used to conduct the relevant analyses. The different meta-analytical methods are illustrated through two examples comparing psychotherapies for panic disorder.

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“…In 2020, Rücker et al 88 used CNMA models to bridge the gap between two disconnected networks of treatments for multiple myeloma and compared the results to those obtained using the matching method through single-arm observational studies. The CNMA model is suitable for a disconnected network with common components shared in different subsets of the network.…”

Section: Component Network Meta-analysismentioning

confidence: 99%

Progress and challenges of network meta‐analysis

Tian

Gao

Zhang

et al. 2021

J Evidence Based Medicine

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Component network meta‐analysis compared to a matching method in a disconnected network: A case study

Abstract: This article has earned an open data badge "Reproducible Research" for making publicly available the code necessary to reproduce the reported results. The results reported in this article were reproduced partially due to their computational complexity.

Cited by 31 publications

References 23 publications

Short-Term Effectiveness and Safety of Biologics and Small Molecule Drugs for Moderate to Severe Atopic Dermatitis: A Systematic Review and Network Meta-Analysis

Short-Term Effectiveness and Safety of Biologics and Small Molecule Drugs for Moderate to Severe Atopic Dermatitis: A Systematic Review and Network Meta-Analysis

A review of methods for addressing components of interventions in meta-analysis

Progress and challenges of network meta‐analysis

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