Academic Journal
Compared efficacy of rituximab, abatacept, and tocilizumab in patients with rheumatoid arthritis refractory to methotrexate or TNF inhibitors agents: a systematic review and network meta-analysis
| العنوان: | Compared efficacy of rituximab, abatacept, and tocilizumab in patients with rheumatoid arthritis refractory to methotrexate or TNF inhibitors agents: a systematic review and network meta-analysis |
|---|---|
| المؤلفون: | Alisson Pugliesi, Amanda Borges de Oliveira, Ana Beatrice Oliveira, Ricardo Xavier, Licia Maria Henrique da Mota, Manoel Barros Bertolo, Miguel Angel Gonzalez-Gay, Gustavo Citera, Luiz Sergio Fernandes de Carvalho |
| المصدر: | Advances in Rheumatology, Vol 63, Iss 1, Pp 1-10 (2023) |
| بيانات النشر: | BMC, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Diseases of the musculoskeletal system LCC:Immunologic diseases. Allergy |
| مصطلحات موضوعية: | Rheumatoid arthritis, Rituximab, Abatacept, Tocilizumab, bDMARD, American college of rheumatology, Diseases of the musculoskeletal system, RC925-935, Immunologic diseases. Allergy, RC581-607 |
| الوصف: | Abstract Background Our aim was to compare the efficacy of rituximab, tocilizumab, and abatacept in individuals with rheumatoid arthritis (RA) refractory to treatments with MTX or TNFi agents. Methods We searched 6 databases until January 2023 for phase 2–4 RCTs evaluating patients with RA refractory to MTX or TNFi therapy treated with rituximab, abatacept, and tocilizumab (intervention arm) compared to controls. Study data were independently assessed by two investigators. The primary outcome was considered as achieving ACR70 response. Results The meta-analysis included 19 RCTs, with 7,835 patients and a mean study duration of 1.2 years. Hazard ratios for achieving an ACR70 response at six months were not different among the bDMARDs, however, we found high heterogeneity. Three factors showing a critical imbalance among the bDMARD classes were identified: baseline HAQ score, study duration, and frequency of TNFi treatment in control arm. Multivariate meta-regression adjusted to these three factors were conducted for the relative risk (RR) for ACR70. Thus, heterogeneity was attenuated (I2 = 24%) and the explanatory power of the model increased (R2 = 85%). In this model, rituximab did not modify the chance of achieving an ACR70 response compared to abatacept (RR = 1.773, 95%CI 0.113–10.21, p = 0.765). In contrast, abatacept was associated with RR = 2.217 (95%CI 1.554–3.161, p |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2523-3106 |
| Relation: | https://doaj.org/toc/2523-3106 |
| DOI: | 10.1186/s42358-023-00298-z |
| URL الوصول: | https://doaj.org/article/1d83565b4cf54c51a501773c721f7c97 |
| رقم الانضمام: | edsdoj.1d83565b4cf54c51a501773c721f7c97 |
| قاعدة البيانات: | Directory of Open Access Journals |
| تدمد: | 25233106 |
|---|---|
| DOI: | 10.1186/s42358-023-00298-z |