Comparative Effectiveness of Combining MTX with Biologic Drug Therapy Versus Either MTX or Biologics Alone for Early Rheumatoid Arthritis in Adults: a Systematic Review and Network Meta-analysis

Journal of General Internal Medicine
Katrina E DonahueMeera Viswanathan

Abstract

Comparative effectiveness of early rheumatoid arthritis (RA) treatments remains uncertain. Compare benefits and harms of biologic drug therapies for adults with early RA within 1 year of diagnosis. English language articles from the 2012 review to October 2017 identified through MEDLINE, Cochrane Library and International Pharmaceutical Abstracts, gray literature, expert recommendations, reference lists of published literature, and supplemental evidence data requests. Two persons independently selected studies based on predefined inclusion criteria. One reviewer extracted data; a second reviewer checked accuracy. Two independent reviewers assigned risk of bias ratings. We identified 22 eligible studies with 9934 participants. Combination therapy with tumor necrosis factor (TNF) or non-TNF biologics plus methotrexate (MTX) improved disease control, remission, and functional capacity compared with monotherapy of either MTX or a biologic. Network meta-analyses found higher ACR50 response (50% improvement) for combination therapy of biologic plus MTX than for MTX monotherapy (relative risk range 1.20 [95% confidence interval (CI), 1.04 to 1.38] to 1.57 [95% CI, 1.30 to 1.88]). No significant differences emerged between treatment di...Continue Reading

References

Nov 30, 2000·The New England Journal of Medicine·J M BathonB K Finck
Nov 6, 2004·Arthritis and Rheumatism·E William St ClairUNKNOWN Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset Study Grou
Mar 2, 2006·Arthritis and Rheumatism·Josef S SmolenE William St Clair
Dec 13, 2006·The American Journal of Clinical Nutrition·Samuele M MarcoraPeter J Maddison
Jul 3, 2008·Annals of the Rheumatic Diseases·J S SmolenUNKNOWN Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset (ASPIRE) S
Sep 30, 2008·Arthritis and Rheumatism·Victoria BejaranoUNKNOWN Yorkshire Early Arthritis Register Consortium
Feb 27, 2010·Arthritis and Rheumatism·Paul EmeryUNKNOWN Combination of Methotrexate and Etanercept in Early Rheumatoid Arthritis Trial Group
Sep 12, 2013·Arthritis and Rheumatism·Christian G AmmitzbøllKristian Stengaard-Pedersen
Feb 8, 2014·BMC Medicine·Ronald F van VollenhovenPaul P Tak
Feb 28, 2015·Journal of Clinical Epidemiology·Nancy D BerkmanStephanie Chang
Oct 30, 2015·Annals of the Rheumatic Diseases·Gerd R BurmesterNina Mitchell
Nov 8, 2015·Arthritis Care & Research·Jasvinder A SinghTimothy McAlindon
Apr 3, 2016·Annals of the Rheumatic Diseases·Josef S SmolenUNKNOWN European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)

❮ Previous
Next ❯

Citations

Sep 19, 2019·Journal of General Internal Medicine·Michael A Fischer, Steven M Asch
Mar 7, 2021·Expert Review of Clinical Immunology·George A KarpouzasSarah R Ormseth

❮ Previous
Next ❯

Software Mentioned

Stata
NWMA
Cochrane Risk of Bias
Risk of Bias Non ( ROBINS - I )
abstrackr
mymeta

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.