Objective The aim of this meta-analysis was to compare the\nefficacy and safety of infliximab-biosimilar and other available\nbiologicals for the treatment of rheumatoid arthritis (RA),\nnamely abatacept, adalimumab, certolizumab pegol, etanercept,\ngolimumab, infliximab, rituximab and tocilizumab.\nMethods A systematic literature review of MEDLINE\ndatabase until August 2013 was carried out to identify\nrelevant randomized controlled trials (RCTs). Bayesian\nmixed treatment comparison method was applied for the\npairwise comparison of treatments. Improvement rates by\nthe American College of Rheumatology criteria (ACR20\nand ACR50) at week 24 were used as efficacy endpoints,\nand the occurrence of serious adverse events was considered\nto assess the safety of the biologicals.\nResults Thirty-six RCTs were included in the meta-analysis.\nAll the biological agents proved to be superior to placebo. For\nACR20 response, certolizumab pegol showed the highest odds\nratio (OR) compared to placebo, OR 7.69 [95 % CI\n3.69ââ?¬â??14.26], followed by abatacept OR 3.7 [95 % CI\n2.17ââ?¬â??6.06], tocilizumab OR 3.69 [95 % CI 1.87ââ?¬â??6.62] and\ninfliximab-biosimilar OR 3.47 [95 % CI 0.85ââ?¬â??9.7]. For\nACR50 response, certolizumab pegol showed the highest OR\ncompared to placebo OR 8.46 [3.74ââ?¬â??16.82], followed by tocilizumab\nOR 5.57 [95 % CI 2.77ââ?¬â??10.09], and infliximab-biosimilar\nOR 4.06 [95 % CI 1.01ââ?¬â??11.54]. Regarding the\noccurrence of serious adverse events, the results show no statistically\nsignificant difference between infliximab-biosimilar\nand placebo, OR 1.87 [95 % CI 0.74ââ?¬â??3.84]. No significant\ndifference regarding efficacy and safety was found between\ninfliximab-biosimilar and the other biological treatments.\nConclusion This is the first indirect meta-analysis inRA that\ncompares the efficacy and safety of biosimilar-infliximab to\nthe other biologicals indicated inRA.We found no significant\ndifference between infliximab-biosimilar and other biological\nagents in terms of clinical efficacy and safety.
Loading....