The impact of autoantibodies on the efficacy of biological disease-modifying anti-rheumatic drugs in rheumatoid arthritis : meta-analysis of randomized controlled trials
© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com..
OBJECTIVE: To investigate the efficacy of bDMARDs in patients with RA with RF/ACPA compared with patients without these autoantibodies.
METHODS: Previous systematic literature reviews performed by EULAR RA management task forces were searched for qualifying RCTs. RCTs investigating the efficacy of bDMARDs and including both autoantibody-positive (≤80% of total population) and -negative RA patients were eligible. For trials comparing bDMARD+csDMARD vs csDMARD, relative risks (RR) comparing two groups (RF + vs RF-, ACPA+ vs ACPA-) were calculated for efficacy outcomes for each arm. Subsequently, relative risk ratios (RRRs) were computed, as the ratio of RR of the bDMARD-arm and the RR from the non-bDMARD-arm. Pooled effects were obtained with random effect meta-analyses.
RESULTS: Data from 28 eligible RCTs were analyzed, pooling 23 studies in three subgroups: 6 including csDMARD-naïve patients, 14 csDMARD-IR, and 3 TNFi-IR patients. In csDMARD-naïve and csDMARD-IR patients, seropositivity was not associated with a better response to bDMARDs: pooled 6-month ACR20 RRRs 1.02 (0.88-1.18) and 1.09 (0.90-1.32), respectively. Other outcomes showed no difference between groups either. In TNFi-IR patients, based on 3 trials, the 6-month ACR20 RRR was 2.28 (1.31-3.95), favoring efficacy in seropositive patients. Other outcomes mostly showed no significant difference between the groups. Based on the mode of action, efficacy was comparable between RF-positive and RF-negative patients for both TNFi and non-TNFi treatment and also for the individual bDMARDs.
CONCLUSION: The effect of bDMARDs is generally comparable in patients with and without RF/ACPA, regardless of the patient population, the mechanism of action or individual drug used.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Rheumatology (Oxford, England) - (2024) vom: 16. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Takase-Minegishi, Kaoru [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-citrullinated protein autoantibodies |
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| Anmerkungen: |
Date Revised 17.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1093/rheumatology/keae113 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM368570126 |
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| 100 | 1 | |a Takase-Minegishi, Kaoru |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of autoantibodies on the efficacy of biological disease-modifying anti-rheumatic drugs in rheumatoid arthritis |b meta-analysis of randomized controlled trials |
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| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a OBJECTIVE: To investigate the efficacy of bDMARDs in patients with RA with RF/ACPA compared with patients without these autoantibodies | ||
| 520 | |a METHODS: Previous systematic literature reviews performed by EULAR RA management task forces were searched for qualifying RCTs. RCTs investigating the efficacy of bDMARDs and including both autoantibody-positive (≤80% of total population) and -negative RA patients were eligible. For trials comparing bDMARD+csDMARD vs csDMARD, relative risks (RR) comparing two groups (RF + vs RF-, ACPA+ vs ACPA-) were calculated for efficacy outcomes for each arm. Subsequently, relative risk ratios (RRRs) were computed, as the ratio of RR of the bDMARD-arm and the RR from the non-bDMARD-arm. Pooled effects were obtained with random effect meta-analyses | ||
| 520 | |a RESULTS: Data from 28 eligible RCTs were analyzed, pooling 23 studies in three subgroups: 6 including csDMARD-naïve patients, 14 csDMARD-IR, and 3 TNFi-IR patients. In csDMARD-naïve and csDMARD-IR patients, seropositivity was not associated with a better response to bDMARDs: pooled 6-month ACR20 RRRs 1.02 (0.88-1.18) and 1.09 (0.90-1.32), respectively. Other outcomes showed no difference between groups either. In TNFi-IR patients, based on 3 trials, the 6-month ACR20 RRR was 2.28 (1.31-3.95), favoring efficacy in seropositive patients. Other outcomes mostly showed no significant difference between the groups. Based on the mode of action, efficacy was comparable between RF-positive and RF-negative patients for both TNFi and non-TNFi treatment and also for the individual bDMARDs | ||
| 520 | |a CONCLUSION: The effect of bDMARDs is generally comparable in patients with and without RF/ACPA, regardless of the patient population, the mechanism of action or individual drug used | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a anti-citrullinated protein autoantibodies | |
| 650 | 4 | |a biological therapies | |
| 650 | 4 | |a rheumatoid arthritis | |
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| 700 | 1 | |a Nam, Jackie L |e verfasserin |4 aut | |
| 700 | 1 | |a Kaneko, Yuko |e verfasserin |4 aut | |
| 700 | 1 | |a Behrens, Frank |e verfasserin |4 aut | |
| 700 | 1 | |a Saevarsdottir, Saedis |e verfasserin |4 aut | |
| 700 | 1 | |a Detert, Jacqueline |e verfasserin |4 aut | |
| 700 | 1 | |a Leirisalo-Repo, Marjatta |e verfasserin |4 aut | |
| 700 | 1 | |a van der Heijde, Désirée |e verfasserin |4 aut | |
| 700 | 1 | |a Landewé, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Ramiro, Sofia |e verfasserin |4 aut | |
| 700 | 1 | |a van der Woude, Diane |e verfasserin |4 aut | |
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