Efficacy of biological agents administered as monotherapy in rheumatoid arthritis: a Bayesian mixed-treatment comparison analysis.

摘要: BACKGROUND: Biological agents provide an important therapeutic alternative for rheumatoid arthritis patients refractory to conventional disease-modifying antirheumatic drugs. Few head-to-head comparative trials are available. PURPOSE: The aim of this meta-analysis was compare the relative efficacy different biologic indicated use as monotherapy in arthritis. METHODS: A systemic literature search performed on electronic databases identify articles reporting double-blind randomized controlled investigating monotherapy. Efficacy assessed using American College Rheumatology (ACR) 20, 50, and 70 criteria at 16-24 weeks. Relative estimated Bayesian mixed-treatment comparison models. Outcome measures were expressed odds ratio 95% credible intervals. RESULTS: Ten selected data extraction analysis. Mixed-treatment analysis revealed that tocilizumab offered 100% probability being best treatment inducing ACR20 response versus placebo, methotrexate, adalimumab, or etanercept. Likewise, ACR50 ACR70 outcome responses, had a 99.8% 98.7% treatment, respectively, compared other treatments placebo. Tocilizumab increased (vs methotrexate) by 3.2-fold (odds ratio: 2.1-3.89) all ACR outcomes. CONCLUSION: greatest possibility obtaining ACR20, ACR50, vs monotherapies