Effect of TNFi on ASAS20, ASAS40 and BASFI in patients with r-axSpA (mNY) (RCTs)
| <2009 (previous SLRs)810 | ≥2009 (current SLR) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Outcome Drug | N patients (Study) | Time-point (weeks) | Response treatment (%) | Response placebo (%) | RR (95% CI) | NNT | N patients (Study) | Time-point (weeks) | Response treatment (%) | Response placebo (%) | RR (95% CI) | NNT |
| ASAS20 | ||||||||||||
| Etanercept | 40 (Gorman et al29) | 16 | 80 | 30 | 2.67 (1.32 to 5.39) | 2.0 | 81 (Dijkmans 200916) | 12 | 60.0 | 23.0 | 2.61 (1.36 to 4.52) | 2.7 |
| 277 (Davis et al 30) | 24 | 57 | 22 | 2.59 (1.80 to 3.57) | 2.9 | 82 (SPINE17) | 12 | 68.4 | 35.9 | 1.91 (1.21 to 3.21) | 3.1 | |
| Infliximab | 279 (ASSERT31) | 24 | 61.2 | 19.2 | 3.18 (2.00 to 5.08) | 2.4 | 76 (Inman 201018) | 12 | 54.0 | 31.0 | 1.74 (1.02 to 3.22) | 4.3 |
| Adalimumab | 315 (ATLAS32) | 12 | 58.2 | 20.6 | 2.83 (1.92 to 4.18) | 2.7 | 261 (Huang 201419) | 12 | 67.2 | 30.4 | 2.21 (1.78 to 3.29) | 2.7 |
| Golimumab | 216* (GO-RAISE33) | 14 | 59.4 | 21.8 | 2.73 (1.75 to 4.24) | 2.7 | 213 (Bao 201420) | 24 | 50.0 | 22.9 | 2.18 (1.55 to 3.45) | 3.7 |
| 41 (Tam 201421) | 24 | 55.0 | 14.0 | 3.93 (1.26 to 11.80) | 2.4 | |||||||
| Certolizumab | NA | NA | NA | NA | NA | NA | 122† (RAPID-axSpA22) | 24 | 67.7 | 33.3 | 2.03 (1.36 to 3.04) | 2.9 |
| ASAS40 | ||||||||||||
| Etanercept | – | – | – | – | – | – | 82 (SPINE17) | 12 | 44.7 | 25.6 | 1.75 (0.99 to 3.59) | 5.2 |
| Infliximab | 279 (ASSERT31) | 24 | 47.0 | 12.0 | 3.92 (2.13 to 7.55) | 2.9 | 76 (Inman 201018) | 12 | 46.0 | 8.0 | 5.75 (1.83 to 17.74) | 2.6 |
| Adalimumab | 315 (ATLAS32) | 12 | 39.4 | 13.1 | 3.01 (1.82 to 5.11) | 3.8 | 344 (Huang 201419) | 12 | 44.5 | 9.6 | 4.64 (2.61 to 8.32) | 2.9 |
| Golimumab | 216* (GO-RAISE33) | 24 | 54.3 | 15.4 | 3.53 (2.05 to 6.08) | 2.6 | – | – | – | – | – | – |
| Certolizumab | NA | NA | NA | NA | NA | NA | 122† (RAPID-axSpA22) | 24 | 47.7 | 15.8 | 3.02 (1.57 to 5.79) | 3.1 |
| N patients (Study) | Time point (weeks) | Impr. treatment mean (SD) | Impr. placebo mean (SD) | SMD (95% CI) | N patients (Study) | Time point (weeks) | Impr. treatment mean (SD) | Impr. placebo mean (SD) | SMD (95% CI) | |||
| BASFI (Δ‡) | ||||||||||||
| Etanercept | 40 (Gorman et al 29) | 16 | 2.3 (−) | 0.1 (−) | n/e | 40 (Barkham 201023) | 12 | 1.35 (−) | −0.21 (−) | n/e | ||
| 277 (Davis et al 30) | 24 | 1.6 (−) | 0.2 (−) | n/e | 82 (SPINE17) | 12 | 2.20 (1.8) | 1.00 (1.8) | 0.19 (−1.31 to 1.68) | |||
| Infliximab | 279 (ASSERT31) | 24 | 1.7 (−) | 0.0 (−) | n/e | – | – | – | – | – | ||
| Adalimumab | 315 (ATLAS32) | – | – | – | – | 261 (Huang 201419) | 12 | 1.8 (2.0) | 0.47 (1.6) | 0.69 (0.46 to 0.92) | ||
| 315 (ATLAS24) | 24 | 2.00 (−) | 0.50 (−) | n/e | ||||||||
| Golimumab | 216† (GO-RAISE33) | 24 | 1.6 (−) | −0.4 (−) | n/e | 213 (Bao 201420) | 24 | 1.26 (2.6) | −0.11 (2.1) | 0.58 (0.30 to 0.85) | ||
| 41 (Tam 201421) | 24 | 1.27 (2.5) | −1.73 (7.2) | 0.55 (−0.08 to 1.16) | ||||||||
| Certolizumab | NA | NA | NA | NA | NA | 122† (RAPID-axSpA22) | 24 | 2.30 (2.4) | 0.90 (1.8) | 0.65 (0.28 to 1.01) | ||
*Golimumab 50 mg versus placebo.
†Certolizumab pegol 200 mg versus placebo.
‡Mean improvement compared to baseline value (range: 0–10).
r-axSpA, radiographic axial spondyloarthritis; mNY, modified New York criteria; NNT, number needed to treat; RR, risk ratio; SMD, standardised mean difference; n/e, not possible to estimate; Impr, improvement; ASAS, Assessment of SpondyloArthritis international Society; BASFI, Bath Ankylosing Spondylitis Functional Index NA, not applicable.