Differences in patients’ population and efficacy/effectiveness of biologic disease–modifying antirheumatic drugs between randomized controlled trials and real-world settings in patients with rheumatoid arthritis – using the IORRA cohort
| Autor: | Katsunori Ikari, Eisuke Inoue, Naohiro Sugitani, N. Sugimoto, Kumiko Saka, R. Yamaguchi, Ryoko Sakai, Eiichi Tanaka, Mai Abe, Masayoshi Harigai, H. Yamanaka, Eri Sugano, Moeko Ochiai, Yoko Higuchi, Ayako Nakajima |
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| Rok vydání: | 2021 |
| Předmět: |
Biological Products
medicine.medical_specialty education.field_of_study business.industry Population Disease medicine.disease law.invention Arthritis Rheumatoid Cohort Studies Rheumatology Randomized controlled trial law Antirheumatic Agents Rheumatoid arthritis Internal medicine Cohort Humans Medicine In patient business Antirheumatic drugs education Randomized Controlled Trials as Topic |
| Zdroj: | Modern Rheumatology. 32:675-685 |
| ISSN: | 1439-7609 1439-7595 |
| Popis: | Objectives To evaluate the differences in patients’ population and efficacy/effectiveness of biological disease–modifying antirheumatic drugs (bDMARDs) between randomized controlled trials (RCTs) and clinical practice in patients with rheumatoid arthritis. Methods We reviewed inclusion criteria in Phase II or III RCTs of bDMARDs conducted in Japan. The Institute of Rheumatology, Rheumatoid Arthritis study participants during the period when each RCT was conducted (Cohort A) and new bDMARD users at our institute in 2016 (Cohort B) were assessed for the fulfilment of the inclusion criteria. The effectiveness of bDMARDs in our cohort and their efficacy in RCTs were compared using the inverse-variance method. Results Nineteen RCTs were selected. The mean proportions of patients fulfilling all inclusion criteria of each RCT in Cohorts A and B were 2.3% and 7.6%, respectively. The pooled proportion ratios (95% confidence interval) for achieving the American College of Rheumatology 20 (ACR20), ACR50, ACR70, and disease activity score 28 remission in non-eligible cases for eight RCTs versus all corresponding RCTs were 0.38 (0.30–0.51), 0.41 (0.30–0.57), 0.54 (0.35–0.82), and 1.28 (1.10–1.56), respectively. Conclusions Few rheumatoid arthritis patients fulfilled the inclusion criteria of the RCTs in clinical settings. There was a difference in the efficacy/effectiveness of bDMARDs between RCTs and clinical practice. |
| Databáze: | OpenAIRE |
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