RESEARCH - Comparison of the efficacy of the TNF-alpha blocking agents Humira, Enbrel, and Remicade

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Ann Rheum Dis. 2003 Nov;62 Suppl 2:ii13-6.

Comparison of the efficacy of the tumour necrosis factor alpha blocking

agents adalimumab, etanercept, and infliximab when added to methotrexate in

patients with active rheumatoid arthritis.

Hochberg MC, JK, Hawkins-Holt M, RH.

Division of Rheumatology and Clinical Immunology, Department of Medicine,

University of land School of Medicine, Baltimore, MD 21201 USA.

mhochber@...

OBJECTIVE: To determine, using the method of adjusted indirect comparisons,

whether there are differences in efficacy of tumour necrosis factor (TNF

alpha) blocking agents, as measured by the rate ratios for American College

of Rheumatology (ACR) 20, 50, and 70 responses, in patients with rheumatoid

arthritis with an incomplete response to methotrexate. METHODS: A systematic

review was performed to identify placebo controlled trials of 24-30 weeks'

duration of combination therapy that used a step-up approach with the

addition of TNF alpha blocking agents to methotrexate. The method of

" adjusted indirect comparisons " was used to compare results across trials to

determine the relative risk for an ACR20 or 50 response. RESULTS: Placebo

controlled trials for adalimumab, etanercept, and infliximab provided data

on ACR20 and 50 responses. Both the similarity of demographic and disease

characteristics of patients at entry, and the homogeneity of response rates

in the placebo groups across trials, suggested that comparing results across

trials was valid. The relative risk for obtaining an ACR20 and 50 response

derived from the adjusted indirect comparisons of the TNF alpha blocking

agents did not significantly differ from unity.

CONCLUSION: The analysis

showed that the three currently marketed TNF alpha blocking agents have

similarly efficacy when added to methotrexate in the treatment of patients

with rheumatoid arthritis with active disease.

PMID: 14532140

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

4532140 & dopt=Citation

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