Indirect Treatment Comparison of Abatacept with Methotrexate Versus Other Biologic Agents for Active Rheumatoid Arthritis Despite Methotrexate Therapy in the United Kingdom

Guyot, Patricia; Taylor, Peter; Christensen, Robin; Pericleous, L.; Drost, Pieter; Eijgelshoven, I.; Bergman, Gert; Lebmeier, M.

doi:10.3899/jrheum.111345

Cited by 21 publications

(8 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While our results stem from an observational cohort, they are similar to two recent systematic reviews based on clinical trials that compared the efficacy of ABA with other biologic agents using Bayesian network meta-analysis methods 9 28 in inadequate responders to MTX. In the first review, ABA was compared with TNF and non-TNF biologics and found to have similar ACR50 and remission rates 9 at 24 and 52 weeks.…”

Section: Discussionsupporting

confidence: 77%

“…In the second review, ABA was compared with anti-TNF agents with similar responses to therapy found based on change in HAQ and ACR response rates at 6 months. 28 A recently published systematic review of randomised clinical trials in patients with inadequate response to nbDMARDs found that use of ABA as compared with anti-TNFs was associated with equivalent ACR20 and ACR50 responses at 6 and 12 months, but there was a higher likelihood of achieving an ACR70 response and DAS28 remission at 12 months with ABA. 29 In contrast, a meta-analysis of randomised clinical trials of patients with inadequate response to MTX suggested a higher probability of achieving an ACR50 response with anti-TNFs as compared with ABA.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The comparative effectiveness of abatacept versus anti-tumour necrosis factor switching for rheumatoid arthritis patients previously treated with an anti-tumour necrosis factor

et al. 2013

View full text Add to dashboard Cite

ObjectiveWe compared the effectiveness of abatacept (ABA) versus a subsequent anti-tumour necrosis factor inhibitor (anti-TNF) in rheumatoid arthritis (RA) patients with prior anti-TNF use.MethodsWe identified RA patients from a large observational US cohort (2/1/2000–8/7/2011) who had discontinued at least one anti-TNF and initiated either ABA or a subsequent anti-TNF. Using propensity score (PS) matching (n:1 match), effectiveness was measured at 6 and 12 months after initiation based on mean change in Clinical Disease Activity Index (CDAI), modified American College of Rheumatology (mACR) 20, 50 and 70 responses, modified Health Assessment Questionnaire (mHAQ) and CDAI remission in adjusted regression models.ResultsThe PS-matched groups included 431 ABA and 746 anti-TNF users at 6 months and 311 ABA and 493 anti-TNF users at 12 months. In adjusted analyses comparing response following treatment with ABA and anti-TNF, the difference in weighted mean change in CDAI (range 6–8) at 6 months (0.46, 95% CI −0.82 to 1.73) and 12 months was similar (−1.64, 95% CI −3.47 to 0.19). The mACR20 responses were similar at 6 (28–32%, p=0.73) and 12 months (35–37%, p=0.48) as were the mACR50 and mACR70 (12 months: 20–22%, p=0.25 and 10–12%, p=0.49, respectively). Meaningful change in mHAQ was similar at 6 and 12 months (30–33%, p=0.41 and 29–30%, p=0.39, respectively) as was CDAI remission rates (9–10%, p=0.42 and 12–13%, p=0.91, respectively).ConclusionsRA patients with prior anti-TNF exposures had similar outcomes if they switched to a new anti-TNF as compared with initiation of ABA.

show abstract

Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

The comparative effectiveness of abatacept versus anti-tumour necrosis factor switching for rheumatoid arthritis patients previously treated with an anti-tumour necrosis factor

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The only available comparisons to date have opposed adalimumab versus tocilizumab or abatacept and included only biologic‐naïve patients. Comparisons of first‐line non‐TNFi bDMARDS rely on indirect comparisons in meta‐analyses and are difficult to interpret . Previous indirect data have suggested a possible superiority of tocilizumab over abatacept for the ACR70 outcome .…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of tocilizumab, abatacept and rituximab after non‐TNF inhibitor failure: results from a multicentre study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…where PE stands for the preserve effect (range: 0 to 1 [100%]). Based on a network meta-analysis by Guyott et al (42) that included 11 randomized trials with 3762 patients who were unresponsive to methotrexate, the RR under a random-effects model for ACR20 at 6 months for any biologics (adalimumab/etanercept/in iximab) vs placebo was approximately 1.80. Similar estimates were obtained considering a combination of both methotrexate-naïve and methotrexate unresponsive patients, in which the frequentist summary RR of achieving ACR20 was 1.81 (random-effects model, 13 trials, 7087 patients) for the comparison adalimumab/etanercept/in iximab vs placebo (43).…”

Section: Margins Of Equivalence: Acr20 Criteriamentioning

confidence: 99%

Equivalence and switching between biosimilars and reference molecules in rheumatoid arthritis: protocol for two systematic reviews and meta-analyses

Ascef

Almeida

Ribeiro

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Biologic drugs such as adalimumab, etanercept, and infliximab represent major first-line and second-line treatments for rheumatoid arthritis (RA) patients. However, their high cost poses a massive burden on healthcare systems worldwide. The expiration of patents for these biologics has driven to the production of biosimilar drugs, which are potentially less costly and remarkably similar, albeit not identical to the reference molecules. These two systematic reviews aim to investigate the efficacy and safety profile of biosimilars compared to biologics (systematic review 1) and the impact of switching between biosimilar drugs and reference biologics on the management of RA patients (systematic review 2).Methods Electronic searches will be performed through MEDLINE (via Pubmed), EMBASE, LILACS, and CENTRAL (from inception to September 2020). Risk of bias assessments will be carried out with the Cochrane risk of bias tool, supplemented with specific domains from equivalence trials. Random-effects models will be fitted to obtain summary estimates using either relative risk or standardized mean difference as a metric. Between-trial heterogeneity will be tested and quantified with the Q-test and I2 metric, respectively, whereas assessment of small-study bias will be examined through contour-enhanced funnel plots and Egger and Harbord's tests. Meta-regression models will be fitted when appropriate. The primary outcome will be the rate of treatment success according to the American College of Rheumatology 20 (ACR20) and the co-primary outcome will be the Patient's self-assessment of physical function (Health Assessment Questionnaire - Disability Index). Conclusions will be based on equivalence hypothesis testing using predefined margins of equivalence elicited from a group of experienced rheumatologists and prior studies. The overall certainty of evidence will be assessed based on the GRADE system.Discussion The two systematic reviews described here, to the best of our knowledge, are the first ones proposing a comprehensive, clinician-oriented approach to assess the equivalence and the impact of switching between biosimilars and biologics on the management of patients with RA. The results will elucidate the efficacy, safety, immunogenicity of biosimilars, and the clinical consequences of substituting biologics with biosimilars in the management of RA. Systematic Review Registration Protocol synopses were previously registered on PROSPERO (CRD42019137152 and CRD42019137155).

show abstract

Indirect Treatment Comparison of Abatacept with Methotrexate Versus Other Biologic Agents for Active Rheumatoid Arthritis Despite Methotrexate Therapy in the United Kingdom

Abstract: Abatacept is expected to result in improvement in functional status comparable to other recommended biologic agents in patients with RA who are unresponsive to MTX in the UK.

Cited by 21 publications

References 25 publications

The comparative effectiveness of abatacept versus anti-tumour necrosis factor switching for rheumatoid arthritis patients previously treated with an anti-tumour necrosis factor

The comparative effectiveness of abatacept versus anti-tumour necrosis factor switching for rheumatoid arthritis patients previously treated with an anti-tumour necrosis factor

Comparative efficacy of tocilizumab, abatacept and rituximab after non‐TNF inhibitor failure: results from a multicentre study

Equivalence and switching between biosimilars and reference molecules in rheumatoid arthritis: protocol for two systematic reviews and meta-analyses

Contact Info

Product

Resources

About