Abstract
Aims: The study aimed to assess the efficacy and safety of tumor necrosis factor inhibitor (TNFI) with methotrexate (MTX) vs. oral triple therapy in patients with active rheumatoid arthritis (RA), showing inadequate response to MTX. Materials and methods: We performed a meta-analysis of three randomized controlled trials (RCTs) (913 MTX-resistant RA patients) to examine the relative efficacy and safety of TNFI-MTX compared to triple therapy (hydroxychloroquine, sulfasalazine, MTX) in patients with RA responding inadequately to MTX. Results: The American College of Rheumatology's 70% improvement (ACR70) response rate was significantly higher for TNFI-MTX patients than for triple therapy-treated controls (RR 1.549, 95% confidence interval (CI) 1.087 - 2.207, p = 0.016). However, the ACR20 and ACR50 response rates did not differ between the TNFI-MTX group and the triple therapy group. The total Sharp score was significantly lower in TNFI-MTXtreated patients than in triple therapy-treated controls (SMD -0.173, 95% CI -0.301 to -0.045, p = 0.008). There was no significant difference related to the number of patients with serious adverse events between the TNFI-MTX group and the triple therapy group (RR 1.033, 95% CI 0.710 - 1.504, p = 0.864); however, TNFI-MTX resulted in higher infection rates than triple therapy (RR 1.513, 95% CI 1.149 - 1.992, p = 0.004). Conclusion: TNFI-MTX was found to be more effective than triple therapy in active RA patients inadequately responsive to MTX, but it is associated with a higher risk of infection.
| Original language | English |
|---|---|
| Pages (from-to) | 263-269 |
| Number of pages | 7 |
| Journal | International Journal of Clinical Pharmacology and Therapeutics |
| Volume | 56 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2018 Jan 1 |
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Keywords
- Efficacy
- Rheumatoid arthritis
- Safety
- TNFI
- Triple therapy
ASJC Scopus subject areas
- Pharmacology
- Pharmacology (medical)
Cite this
Comparative efficacy and safety of TNF-inhibitor plus methotrexate versus oral triple therapy in patients with active rheumatoid arthritis inadequately responding to methotrexate : A meta-analysis of randomized controlled trials. / Bae, Sang Cheol; Lee, Young Ho.
In: International Journal of Clinical Pharmacology and Therapeutics, Vol. 56, No. 6, 01.01.2018, p. 263-269.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparative efficacy and safety of TNF-inhibitor plus methotrexate versus oral triple therapy in patients with active rheumatoid arthritis inadequately responding to methotrexate
T2 - A meta-analysis of randomized controlled trials
AU - Bae, Sang Cheol
AU - Lee, Young Ho
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Aims: The study aimed to assess the efficacy and safety of tumor necrosis factor inhibitor (TNFI) with methotrexate (MTX) vs. oral triple therapy in patients with active rheumatoid arthritis (RA), showing inadequate response to MTX. Materials and methods: We performed a meta-analysis of three randomized controlled trials (RCTs) (913 MTX-resistant RA patients) to examine the relative efficacy and safety of TNFI-MTX compared to triple therapy (hydroxychloroquine, sulfasalazine, MTX) in patients with RA responding inadequately to MTX. Results: The American College of Rheumatology's 70% improvement (ACR70) response rate was significantly higher for TNFI-MTX patients than for triple therapy-treated controls (RR 1.549, 95% confidence interval (CI) 1.087 - 2.207, p = 0.016). However, the ACR20 and ACR50 response rates did not differ between the TNFI-MTX group and the triple therapy group. The total Sharp score was significantly lower in TNFI-MTXtreated patients than in triple therapy-treated controls (SMD -0.173, 95% CI -0.301 to -0.045, p = 0.008). There was no significant difference related to the number of patients with serious adverse events between the TNFI-MTX group and the triple therapy group (RR 1.033, 95% CI 0.710 - 1.504, p = 0.864); however, TNFI-MTX resulted in higher infection rates than triple therapy (RR 1.513, 95% CI 1.149 - 1.992, p = 0.004). Conclusion: TNFI-MTX was found to be more effective than triple therapy in active RA patients inadequately responsive to MTX, but it is associated with a higher risk of infection.
AB - Aims: The study aimed to assess the efficacy and safety of tumor necrosis factor inhibitor (TNFI) with methotrexate (MTX) vs. oral triple therapy in patients with active rheumatoid arthritis (RA), showing inadequate response to MTX. Materials and methods: We performed a meta-analysis of three randomized controlled trials (RCTs) (913 MTX-resistant RA patients) to examine the relative efficacy and safety of TNFI-MTX compared to triple therapy (hydroxychloroquine, sulfasalazine, MTX) in patients with RA responding inadequately to MTX. Results: The American College of Rheumatology's 70% improvement (ACR70) response rate was significantly higher for TNFI-MTX patients than for triple therapy-treated controls (RR 1.549, 95% confidence interval (CI) 1.087 - 2.207, p = 0.016). However, the ACR20 and ACR50 response rates did not differ between the TNFI-MTX group and the triple therapy group. The total Sharp score was significantly lower in TNFI-MTXtreated patients than in triple therapy-treated controls (SMD -0.173, 95% CI -0.301 to -0.045, p = 0.008). There was no significant difference related to the number of patients with serious adverse events between the TNFI-MTX group and the triple therapy group (RR 1.033, 95% CI 0.710 - 1.504, p = 0.864); however, TNFI-MTX resulted in higher infection rates than triple therapy (RR 1.513, 95% CI 1.149 - 1.992, p = 0.004). Conclusion: TNFI-MTX was found to be more effective than triple therapy in active RA patients inadequately responsive to MTX, but it is associated with a higher risk of infection.
KW - Efficacy
KW - Rheumatoid arthritis
KW - Safety
KW - TNFI
KW - Triple therapy
UR - http://www.scopus.com/inward/record.url?scp=85048045121&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048045121&partnerID=8YFLogxK
U2 - 10.5414/CP203202
DO - 10.5414/CP203202
M3 - Article
C2 - 29578394
AN - SCOPUS:85048045121
VL - 56
SP - 263
EP - 269
JO - International Journal of Clinical Pharmacology and Therapeutics
JF - International Journal of Clinical Pharmacology and Therapeutics
SN - 0946-1965
IS - 6
ER -