A Network Meta-Analysis to Compare Effectiveness of Baricitinib and Other Treatments in Rheumatoid Arthritis Patients with Inadequate Response to Methotrexate
| Autor: | Claudia Nicolay, Inmaculada de la Torre, Walid D. Fakhouri, Xiaofei Wang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
rheumatoid arthritis medicine.medical_specialty Population efficacy lcsh:Computer applications to medicine. Medical informatics Gastroenterology law.invention Autoimmune Diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Randomized controlled trial law immune system diseases JAK 1/2 inhibitor Internal medicine medicine Adalimumab baricitinib biologics 030212 general & internal medicine education skin and connective tissue diseases network meta-analysis 030203 arthritis & rheumatology education.field_of_study business.industry Health Policy Abatacept Public Health Environmental and Occupational Health medicine.disease Infliximab chemistry Rheumatoid arthritis lcsh:R858-859.7 Methotrexate business medicine.drug |
| Zdroj: | Journal of Health Economics and Outcomes Research |
| ISSN: | 2327-2236 2326-697X |
| Popis: | Background/Objectives: This article compares the effectiveness of baricitinib (BARI) 4 mg (oral, Janus kinase [JAK] 1/2 inhibitor) versus other targeted synthetic/biologic disease-modifying antirheumatic drugs, in combination with methotrexate (MTX), in moderate-to-severe rheumatoid arthritis patients with inadequate response (IR) to MTX. Methods: A systematic literature review was conducted to identify randomized controlled trials (RCTs) of the interventions of interest. Bayesian network meta-analyses (NMA) were used to compare American College of Rheumatology (ACR) responses at 24 weeks. A series of prespecified sensitivity analyses addressed the potential impact of, among others, baseline risk, treatment effect modifiers, and trial design on treatment response. Results: Nineteen RCTs were included in the NMA (primary analysis). For ACR20, BARI 4 mg + MTX was found to be more effective than adalimumab (ADA) 40 mg + MTX (Odds Ratio [OR] 1.33), abatacept (ABA) 10 mg + MTX (IV/4 weeks) (OR 1.45), infliximab (IFX) 3 mg + MTX (IV/8 wks) (OR 1.63), and rituximab (RTX) 1000 mg + MTX (OR 1.63). No differences were found on ACR50. For ACR70, BARI 4 mg + MTX was more effective than ADA 40 mg + MTX (OR 1.37), ABA 10 mg + MTX (OR 1.86), and RTX 1000 mg + MTX (OR 2.26). Sensitivity analysis including 10 additional RCTs with up to 20% of patients with prior biologic use showed BARI 4 mg + MTX to be more effective than tocilizumab (TCZ) 8 mg + MTX on ACR20 (OR 1.44). Results for all sensitivity analyses were consistent with the direction and magnitude of the primary results. Key limitations include the time span in which trials were conducted (1999–2017), during which patient characteristics and treatment approaches might have changed. Conclusion: This NMA suggests that BARI 4 mg + MTX is an efficacious treatment option in the MTX-IR population as evidenced by the robustness of results. |
| Databáze: | OpenAIRE |
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