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Systematic review and network meta-analysis: effect of biologics on radiographic progression in rheumatoid arthritis

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Murray E1, Ellis A1, Butylkova Y1, Skup M2, Kalabic J3, Garg V2. J Comp Eff Res. 2018 Aug 21. doi: 10.2217/cer-2017-0106. [Epub ahead of print]


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1 Doctor Evidence, Santa Monica, CA, 90401, USA.

2 AbbVie, North Chicago, IL, 60064, USA.

3 AbbVie Deutschland GmbH & Co. KG, Ludwigshafen, Germany.


AIM: To evaluate the comparative effectiveness of biologics in inhibiting radiographic progression among rheumatoid arthritis(RA) patients.

MATERIALS & METHODS: Bayesian network meta-analysis of published trials investigating the USA FDA approved biologics treatment in RA patients, using methotrexate (MTX) as the reference comparator.

RESULTS: Nine trials met the inclusion criteria for base case analysis. Compared with MTX, most biologics (except golimumab) + MTX had significantly lower rates of radiographic progression at 1 year. Mean difference in radiographic progression rates between MTX monotherapy and biologics + MTX was highest for adalimumab + MTX (-3.8) and lowest for tocilizumab + MTX (-0.7). Inhibition of radiographic progression was sustained.

CONCLUSION: Biologics inhibit radiographic progression in patients with RA at 1 year; however, published evidence beyond 1 year is limited.