Tumor necrosis factor alpha drugs in rheumatoid arthritis: systematic review and metaanalysis of efficacy and safety

Alonso-Ruiz, A; Pijoán, José Ignacio; Ansuategui, Eukene; Urkaregi, Arantza; Calabozo, M; Quintana, Antonio García

doi:10.1186/1471-2474-9-52

Cited by 216 publications

(160 citation statements)

References 60 publications

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“…The metaanalyses by Kristensen, et al and Nixon, et al concluded to equal efficacy for 3 anti-TNF-α agents: infliximab, etanercept, and adalimumab 9,11 , while that by Alonzo-Ruiz, et al determined equal efficacy for etanercept or adalimumab and MTX 10 . In contrast, 2 metaanalyses determined the superiority of anti-TNF-α agents in comparison with anakinra 11,13 .…”

Section: Discussionmentioning

confidence: 98%

Comparison of Certolizumab Pegol with Other Anticytokine Agents for Treatment of Rheumatoid Arthritis: A Multiple-treatment Bayesian Metaanalysis

Launois¹,

Avouac²,

Bérenbaum³

et al. 2011

J Rheumatol

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Objective.To compare the clinical efficacy of certolizumab pegol (CZP) with that of other anticytokine agents indicated for the treatment of rheumatoid arthritis (RA) with identical therapeutic indication (anti-tumor necrosis factor-α, anti-interleukin 1 or 6), with the objective of determining the noninferiority of CZP.Methods.A systematic review was performed to identify randomized controlled trials that assessed the efficacy of anticytokine agents in combination with conventional disease-modifying antirheumatic drugs (DMARD) after 6 months of treatment, using the American College of Rheumatology (ACR) response criteria, in patients with RA who have shown inadequate response to DMARD including methotrexate. Indirect treatment comparisons were carried out by a multiple-treatment Bayesian random-effects metaanalysis. Data were analyzed using the Markov chain Monte Carlo simulation. Noninferiority of CZP was assessed in comparison with a predefined equivalence margin of 5%.Results.Nineteen placebo-controlled studies were identified: 14 evaluated the efficacy of 5 anti-TNF-α agents (infliximab, etanercept, adalimumab, golimumab, CZP) and 5 evaluated efficacy of 2 anti-interleukin agents (anakinra, tocilizumab). Every treatment showed significant efficacy versus placebo in individual studies. The multiple-treatment metaanalysis showed a highest OR for CZP on ACR20 response. Metaanalysis indicates that the efficacy of CZP according to ACR20 response is superior to that of infliximab, adalimumab, and anakinra, and equivalent or superior to that of etanercept, golimumab, and tocilizumab. According to ACR50 response, the efficacy of CZP is equivalent or superior to that of all other anticytokines.Conclusion.Results of this original multiple-treatment Bayesian metaanalysis indicate that certolizumab pegol is at least as efficacious as the preexisting antirheumatic anticytokine biotherapies.

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Section: Discussionmentioning

confidence: 98%

Comparison of Certolizumab Pegol with Other Anticytokine Agents for Treatment of Rheumatoid Arthritis: A Multiple-treatment Bayesian Metaanalysis

Launois¹,

Avouac²,

Bérenbaum³

et al. 2011

J Rheumatol

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“…Clinical trial and postmarketing surveillance data have indicated an increased risk of certain adverse events (AE) associated with biologic DMARD use: Mycobacterium tuberculosis (TB) and other opportunistic infections 8 , certain autoimmune events 9,10 , malignancies 11,12 , and infusion-site reactions 13 . Determining whether there is an increase in the risk of safety events with increasing biologic exposure is of particular clinical relevance given the chronic expression of the disease and longterm treatment required.…”

mentioning

confidence: 99%

Safety of Abatacept Administered Intravenously in Treatment of Rheumatoid Arthritis: Integrated Analyses of up to 8 Years of Treatment from the Abatacept Clinical Trial Program

Weinblatt

Moreland²,

Westhovens³

et al. 2013

J Rheumatol

123

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Objective.To assess the overall safety, including rare events, of intravenous (IV) abatacept treatment in rheumatoid arthritis (RA).Methods.Data from 8 clinical trials of IV abatacept in RA were pooled. Safety events were assessed during the short-term (duration ≤ 12 months) and cumulative (short-term plus longterm extensions) abatacept treatment periods. Incidence rates per 100 patient-years were calculated. Standardized incidence ratios (SIR) for hospitalized infections and malignancies were compared with external RA cohorts and, for malignancies, with the US general population.Results.There were 3173 IV abatacept-treated patients with 2331 patient-years of exposure in the short-term periods, and 4149 IV abatacept-treated patients with 12,132 patient-years of exposure in the cumulative period. Incidence rates for serious infections were low and consistent over time (3.68 for abatacept vs 2.60 for placebo during the short-term, and 2.87 for abatacept during the cumulative period). Hospitalized infections were generally similar to external RA patient cohorts and were consistent over time. Incidence rates of malignancies were similar for abatacept- and placebo-treated patients during the short-term period (0.73 vs 0.59) and remained low during the abatacept cumulative period (0.73). SIR of some tissue-specific malignancies (e.g., colorectal and breast) in the cumulative period tended to be lower, while others (lymphoma and lung) tended to be higher, compared with the general population; however, incidence rates were comparable with RA cohorts. Autoimmune events were rare and infusion reactions uncommon.Conclusion.Longterm safety of IV abatacept was consistent with the short-term, with no unexpected events and low incidence rates of serious infections, malignancies, and autoimmune events.

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“…This association with nonmelanoma skin cancers and anti-TNF therapy was also seen in a second larger US observational study (3). As a third example, we refer to the clustering of a rare lymphoma subtype in children with inflammatory bowel disease treated with monoclonal antibodies to TNF (4,5).…”

Section: To the Editorsmentioning

confidence: 55%

Care needs to be taken when reviewing malignancy data reported from observational studies: Comment on the article by Onel and Onel

Mariette

Reynolds²,

Emery

2011

Arthritis Care & Research

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Tumor necrosis factor alpha drugs in rheumatoid arthritis: systematic review and metaanalysis of efficacy and safety

Abstract: Background: To analyse available evidence on the efficacy and safety of anti-TNF drugs (infliximab, etanercept and adalimumab) for treating rheumatoid arthritis (RA).

Cited by 216 publications

References 60 publications

Comparison of Certolizumab Pegol with Other Anticytokine Agents for Treatment of Rheumatoid Arthritis: A Multiple-treatment Bayesian Metaanalysis

Comparison of Certolizumab Pegol with Other Anticytokine Agents for Treatment of Rheumatoid Arthritis: A Multiple-treatment Bayesian Metaanalysis

Safety of Abatacept Administered Intravenously in Treatment of Rheumatoid Arthritis: Integrated Analyses of up to 8 Years of Treatment from the Abatacept Clinical Trial Program

Care needs to be taken when reviewing malignancy data reported from observational studies: Comment on the article by Onel and Onel

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