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Comparison of certolizumab pegol with other anticytokine agents for treatment of rheumatoid arthritis: A multiple-treatment Bayesian metaanalysis
The Journal of Rheumatology, 01/21/2011
Clinical Article
Launois R et al. – Results of this original multiple-treatment Bayesian metaanalysis indicate that certolizumab pegol is at least as efficacious as the preexisting antirheumatic anticytokine biotherapies.
Methods- Systematic review performed to identify randomized controlled trials that assessed efficacy of anticytokine agents in combination with conventional disease-modifying antirheumatic drugs (DMARD) after 6 months of treatment, using American College of Rheumatology (ACR) response criteria, in patients with RA who have shown inadequate response to DMARD including methotrexate
- Indirect treatment comparisons carried out by multiple-treatment Bayesian random-effects metaanalysis
- Data analyzed using Markov chain Monte Carlo simulation
- Noninferiority of CZP assessed in comparison with predefined equivalence margin of 5%
- Nineteen placebo-controlled studies were identified: 14 evaluated efficacy of 5 anti-TNF-α agents (infliximab, etanercept, adalimumab, golimumab, CZP) and 5 evaluated efficacy of 2 anti-interleukin agents (anakinra, tocilizumab)
- Every treatment showed significant efficacy versus placebo in individual studies
- Multiple-treatment metaanalysis showed a highest OR for CZP on ACR20 response
- Metaanalysis indicates that efficacy of CZP according to ACR20 response is superior to that of infliximab, adalimumab, and anakinra, and equivalent or superior to that of etanercept, golimumab, and tocilizumab
- According to ACR50 response, efficacy of CZP is equivalent or superior to that of all other anticytokines
