Effect of TNFi on ASAS20, ASAS40 and BASFI in patients with nr-axSpA (ASAS criteria) (RCTs)
| Outcome Drug | N patients (Study) | Time point (weeks) | Response treatment (%) | Response placebo (%) | RR (95% CI) | NNT |
|---|---|---|---|---|---|---|
| ASAS20 | ||||||
| Etanercept | 215 (EMBARK25) | 12 | 52.4 | 36.1 | 1.45 (1.06 to 1.90) | 6.1 |
| Infliximab* | – | – | – | – | – | – |
| Adalimumab | 185 (ABILITY-127) | 12 | 51.6 | 30.9 | 1.67 (1.17 to 2.40) | 4.8 |
| Golimumab | 198 (GO-AHEAD28) | 16 | 71.1 | 40.0 | 1.78 (1.43 to 2.43) | 3.2 |
| Certolizumab | 96† (RAPID-axSpA22) | 24 | 65.2 | 24.0 | 2.72 (1.59 to 4.65) | 2.4 |
| ASAS40 | ||||||
| Etanercept | 215 (EMBARK25) | 12 | 33.3 | 14.8 | 2.25 (1.33 to 3.81) | 5.4 |
| Infliximab* | 40 (Barkham 200926) | 16 | 61.1 | 17.6 | 3.47 (1.16 to 10.31) | 2.3 |
| Adalimumab | 185 (ABILITY-127) | 12 | 36.3 | 14.9 | 2.44 (1.40 to 4.25) | 4.7 |
| Golimumab | 198 (GO-AHEAD28) | 16 | 56.7 | 23.0 | 2.47 (1.67 to 3.70) | 3.0 |
| Certolizumab | 96† (RAPID-axSpA22) | 24 | 56.5 | 14.0 | 4.04 (1.94 to 8.40) | 2.7 |
| Impr. mean (SD) | Impr. mean (SD) | SMD (95% CI) | ||||
| BASFI (Δ‡) | ||||||
| Etanercept | 215 (EMBARK25) | 12 | 1.40 (0.2) | 0.80 (0.2) | 3.00 (2.61 to 3.39) | |
| Infliximab* | 40 (Barkham 200926) | 16 | 2.70 (2.36) | 0.47 (2.25) | 0.97 (0.31 to 1.62) | |
| Adalimumab | 185 (ABILITY-127) | 12 | 1.10 (−) | 0.60 (−) | n/e | |
| Golimumab | – | – | – | – | – | |
| Certolizumab | 96† (RAPID-axSpA22) | 24 | 2.50 (2.4) | 0.10 (2.3) | 1.02 (0.59 to 1.44) | |
*nr-axSpA defined by: inflammatory back pain (Calin definition) within 3 months to 3 years AND sacroiliitis on MRI AND HLA-B27 positivity.
†Certolizumab pegol 200 mg versus placebo.
‡Mean improvement compared to baseline value (range: 0–10).
ASAS, Assessment in SpondyloArthritis international Society; BASFI, Bath Ankylosing Spondylitis Functional Index; HLA, human leucocyte antigen; Impr, improvement; NA, not applicable; n/e, not possible to estimate; nr-axSpA, non-radiographic axial spondyloarthritis; NNT, number needed to treat; RR, risk ratio; SMD, standardised mean difference.