Efficacy of biological disease-modifying antirheumatic drugs
| Autor: | Ronald F van Vollenhoven, Désirée van der Heijde, Marieke Scholte-Voshaar, Sofia Ramiro, Kaoru Takase-Minegishi, Josef S Smolen, Johannes W. J. Bijlsma, Jackie L Nam, Katerina Chatzidionysiou, Gerd R Burmester, Robert Landewé, Maxime Dougados |
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| Přispěvatelé: | Other departments, AII - Inflammatory diseases, Clinical Immunology and Rheumatology, AMS - Amsterdam Movement Sciences, AII - Amsterdam institute for Infection and Immunity, Rheumatology |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Immunology Advisory Committees MEDLINE Disease General Biochemistry Genetics and Molecular Biology Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine medicine Immunology and Allergy Humans Biosimilar Pharmaceuticals Randomized Controlled Trials as Topic 030203 arthritis & rheumatology Biological Products business.industry Drug Substitution Tumor Necrosis Factor-alpha Biosimilar medicine.disease 030104 developmental biology Systematic review Rheumatoid arthritis Antirheumatic Agents Practice Guidelines as Topic Drug Therapy Combination Antirheumatic drugs business Rheumatism |
| Zdroj: | Nam, J L, Takase-Minegishi, K, Ramiro, S, Chatzidionysiou, K, Smolen, J S, Van Der Heijde, D, Bijlsma, J W, Burmester, G R, Dougados, M, Scholte-Voshaar, M, Van Vollenhoven, R & Landewé, R 2017, ' Efficacy of biological disease-modifying antirheumatic drugs : A systematic literature review informing the 2016 update of the EULAR recommendations for the management of rheumatoid arthritis ', Annals of the Rheumatic Diseases, vol. 76, no. 6, pp. 1108-1113 . https://doi.org/10.1136/annrheumdis-2016-210713 Annals of the rheumatic diseases, 76(6), 1113-1136. BMJ Publishing Group Annals of the Rheumatic Diseases, 76(6), 1108-1113. BMJ Publishing Group |
| ISSN: | 0003-4967 |
| Popis: | ObjectivesTo update the evidence for the efficacy of biological disease-modifying antirheumatic drugs (bDMARDs) in patients with rheumatoid arthritis (RA) to inform European League Against Rheumatism (EULAR) Task Force treatment recommendations.MethodsMEDLINE, EMBASE and Cochrane databases were searched for phase III or IV (or phase II, if these studies were lacking) randomised controlled trials (RCTs) published between January 2013 and February 2016. Abstracts from the American College of Rheumatology and EULAR conferences were obtained.ResultsThe RCTs confirmed greater efficacy with a bDMARD+conventional synthetic DMARD (csDMARD) versus a csDMARDs alone (level 1A evidence). Using a treat-to-target strategy approach, commencing and escalating csDMARD therapy and adding a bDMARD in cases of non-response, is an effective approach (1B). If a bDMARD had failed, improvements in clinical response were seen on switching to another bDMARD (1A), but no clear advantage was seen for switching to an agent with another mode of action. Maintenance of clinical response in patients in remission or low disease activity was best when continuing rather than stopping a bDMARD, but bDMARD dose reduction or ‘spacing’ was possible, with a substantial proportion of patients achieving bDMARD-free remission (2B). RCTs have also demonstrated efficacy of several new bDMARDs and biosimilar DMARDs (1B).ConclusionsThis systematic literature review consistently confirmed the previously reported efficacy of bDMARDs in RA and provided additional information on bDMARD switching and dose reduction. |
| Databáze: | OpenAIRE |
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