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Different original and biosimilar TNF inhibitors similarly reduce joint destruction in rheumatoid arthritis-A network meta-analysis of 36 randomized controlled trials

Research output: Contribution to journalArticle

Original languageEnglish
Article number4350
Number of pages19
JournalInternational Journal of Molecular Sciences
Volume20
Issue number18
DOIs
DateAccepted/In press - 29 Aug 2019
DatePublished (current) - 5 Sep 2019

Abstract

The effect of five approved tumour necrosis factor inhibitors (TNFi: infliximab, etanercept, adalimumab, certolizumab, and golimumab) on joint destruction in rheumatoid arthritis (RA) have been compared versus methotrexate (MTX) in randomized controlled trials (RCTs) but have not been compared directly to each other or to an otherwise untreated placebo control. The present analysis compares effects of standard doses, high doses, and low doses of TNFis on radiographic joint destruction in RA and relate these effects to MTX and placebo by means of a Bayesian network meta-analysis. We identified 31 RCTs of the effect of TNFis on joint destruction and 5 RCTs with controls, which indirectly could link otherwise untreated placebo controls to the TNFi treatments in the network. The previously untested comparison with placebo was performed to estimate not only the effect relative to another drug, but also the absolute attainable effect. Compared to placebo there was a highly significant inhibitory effect on joint destruction of infliximab, etanercept, adalimumab, certolizumab, and golimumab, which was about 0.9% per year as monotherapy and about 1.2% per year when combined with MTX. Although significantly better than MTX and placebo, golimumab seemed inferior to the remaining TNFis. There was no difference between original reference drugs (Remicade, Enbrel) and the almost identical copy drugs (biosimilars).

    Research areas

  • rheumatoid arthritis, tumor necrosis factor (TNF) inhibitors, joint destruction, randomized controlled trial, network meta-analysis

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  • Full-text PDF (final published version)

    Rights statement: This is the final published version of the article (version of record). It first appeared online via MDPI at https://doi.org/10.3390/ijms20184350 . Please refer to any applicable terms of use of the publisher.

    Final published version, 623 KB, PDF document

    Licence: CC BY

  • Full-text PDF (final published version)

    Rights statement: This is the final published version of the article (version of record). It first appeared online via MPDI at https://www.mdpi.com/1422-0067/20/18/4350. Please refer to any applicable terms of use of the publisher.

    Final published version, 623 KB, PDF document

    Licence: CC BY

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