Comparative Efficacy of Tumor Necrosis Factor-α Inhibitors in Ankylosing Spondylitis: A Systematic Review and Bayesian Network Metaanalysis

摘要: Objective. To compare the efficacy of 6 tumor necrosis factor–α inhibitors (TNFi) in treatment ankylosing spondylitis (AS) at 12 weeks and 24 weeks. Methods. We performed a systematic literature review randomized controlled trials TNFi patients with active AS. included that reported 10 to 14 (12–week analysis) 30 (24-week analysis). used Bayesian network metaanalysis (NMA) their relative improve Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Functional (BASFI), C-reactive protein (CRP) level. Results. 20 TNFi, 43 arms 3220 participants. All were significantly better than placebo reducing BASDAI BASFI weeks; all but certolizumab pegol (CZP) statistically CRP CZP infliximab-dyyb (IFX biosimilar) IFX was superior other decreasing weeks, not Excluding 1 open-label trial, there no differences among TNFi. Conclusion. Based on this NMA clinical trials, sensitive inclusion an its diminished The analysis limited by few direct comparison trials. Further study safety longterm effectiveness will help inform choice treating