RT Journal Article
SR Electronic
T1 Efficacy and safety of biologics in psoriatic arthritis: a systematic literature review and network meta-analysis
JF RMD Open
JO RMD Open
FD EULAR
SP e001117
DO 10.1136/rmdopen-2019-001117
VO 6
IS 1
A1 Adeline Ruyssen-Witrand
A1 Richard Perry
A1 Clare Watkins
A1 George Braileanu
A1 Gayathri Kumar
A1 Sandeep Kiri
A1 Debby Nott
A1 Soyi Liu-Leage
A1 Susanne Hartz
A1 Christophe Sapin
YR 2020
UL http://rmdopen.bmj.com/content/6/1/e001117.abstract
AB Background Biologic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs are used in patients with psoriatic arthritis (PsA), but few studies directly compare their clinical efficacy. In such situations, network meta-analysis (NMA) can inform evidence-based decision-making.Objective To evaluate the comparative efficacy and safety of approved bDMARDs in patients with PsA.Methods Bayesian NMA was conducted to compare the clinical efficacy of bDMARDs at weeks 12‒16 in bDMARD-naïve patients with PsA in terms of American College of Rheumatology (ACR) criteria, Psoriatic Arthritis Response Criteria (PsARC) and Psoriasis Area and Severity Index (PASI). Safety end points were evaluated in the overall mixed population of bDMARD-naive and bDMARD-experienced patients.Results For ACR, all treatments except abatacept were statistically superior to placebo. Infliximab was most effective, followed by golimumab and etanercept, which were statistically superior to most other treatments. Ixekizumab 80 mg every 2 weeks (Q2W) was statistically superior to abatacept subcutaneous, apremilast and both regimens of ustekinumab; similar findings were observed for ixekizumab 80 mg Q4W. For PsARC response, ixekizumab did not significantly differ from other therapies, except for golimumab, infliximab and etanercept, which were superior to most other agents including ixekizumab. For PASI response, infliximab was numerically most effective, but was not statistically superior to ixekizumab, which was the next best performing agent. Analysis of safety end points identified few differences between treatments.Conclusion Our NMA confirms the efficacy and acceptable safety profile of bDMARDs in patients with active PsA. There were generally few statistically significant differences between most treatments.