Evidence mapPaperPMID 27253239Full record

SynthesisThe Korean journal of internal medicine2017

Comparative efficacy of biological agents in methotrexate-refractory rheumatoid arthritis patients: a Bayesian mixed treatment comparison.

Miyoung Choi, Min Kyung Hyun, Seongmi Choi, Ha Jin Tchoe, Sung Yeon Lee, Kyeong Min Son, Min-Jeong Kim, Young Ok Jung, Hyun Ah Kim

Open access · goldAbstract readComparative StudyMeta-Analysis
In one paragraph

Synthesis in The Korean journal of internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Miyoung ChoiNational Evidence-Based Healthcare Collaboration Agency (NECA), Seoul, Korea.
Min Kyung HyunDepartment of Preventive Medicine, Dongguk University College of Korean Medicine, Seoul, Korea.
Seongmi ChoiKorea Appraisal Board, Real Estate R&D Institute, Seoul, Korea.
Ha Jin TchoeNational Evidence-Based Healthcare Collaboration Agency (NECA), Seoul, Korea.
Sung Yeon LeeDepartment of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
Kyeong Min SonDepartment of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
Min-Jeong KimNational Evidence-Based Healthcare Collaboration Agency (NECA), Seoul, Korea.
Young Ok JungDepartment of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
Hyun Ah KimDepartment of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
National Evidenc- based healthcare Collaborating Agency · KRHallym University Sacred Heart Hospital · KRDongguk University · KRHallym University Chuncheon Sacred Heart Hospital · KRHallym University Kangnam Sacred Heart Hospital · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsBiological agents (biologics) targeting proinflammatory signaling have emerged as an important treatment option in rheumatoid arthritis (RA). Despite the clinical effectiveness of biologics for patients with RA who do not respond to 'traditional' disease-modifying anti-rheumatic drugs (DMARDs), there are concerns regarding their cost and long-term safety. In this study, we aimed to compare the efficacy of various biologics and traditional DMARDs in RA patients refractory to methotrexate (MTX).

methodsFour DMARDs (hydroxychloroquine, sulfasalazine, MTX, lef lunomide) and five anti-tumor necrosis factor drugs (adalimumab, etanercept, golimumab, inf liximab, and certolizumab) were selected. A systematic search of published studies was performed from inception through July 2013. Randomized trials of adults with MTX-refractory RA comparing two or more of the selected medications were included. Among 7,938 titles identified, in total, 16 head-to-head trials were selected. Two reviewers independently abstracted the study data and assessed methodological quality using the Cochrane Risk of Bias. Comparative efficacy was analyzed using a Bayesian mixed treatment comparison (MTC).

resultsIn total, 9, 4, and 11 studies were included for the outcome measures of the Health Assessment Questionnaire (HAQ), Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) < 2.6 (remission), and American College of Rheumatology (ACR) 70 response, respectively. The treatments with the highest efficacy for each outcome measure were certolizumab combined with MTX, golimumab combined with MTX, and certolizumab combined with MTX, respectively.

conclusionsBased on MTC analysis, using data from published randomized controlled trials, certolizumab and golimumab combined with MTX showed the highest efficacy in the three outcome measures (HAQ, DAS28-ESR < 2.6, and ACR 70 response) in MTX-refractory RA patients.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidBayes TheoremHumansTreatment OutcomeAntirheumatic AgentsAntirheumatic agentsArthritis, rheumatoidBiological productsMixed treatment comparison

Identifiers

PMID27253239
PMCPMC5432786
OpenAlexW2418349657

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.