Evidence map›Paper›PMID 30022333›Full record

SynthesisEuropean journal of clinical pharmacology2018

Discontinuation of non-anti-TNF drugs for rheumatoid arthritis in interventional versus observational studies: a systematic review and meta-analysis.

Fernanda S Tonin, Laiza M Steimbach, Leticia P Leonart, Vinicius L Ferreira, Helena H Borba, Thais Piazza, Ariane G Araújo, Fernando Fernandez-Llimos, Roberto Pontarolo, Astrid Wiens

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 35% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Review
  4. 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

10 authors at 2 institutions in 2 countries.

Fernanda S ToninUniversidade Federal do Paraná, Curitiba, Brazil.
Laiza M SteimbachUniversidade Federal do Paraná, Curitiba, Brazil.
Leticia P LeonartUniversidade Federal do Paraná, Curitiba, Brazil.
Vinicius L FerreiraUniversidade Federal do Paraná, Curitiba, Brazil.
Helena H BorbaDepartment of Pharmacy, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, Curitiba, Paraná, Brazil.
Thais PiazzaUniversidade Federal do Paraná, Curitiba, Brazil.
Ariane G AraújoUniversidade Federal do Paraná, Curitiba, Brazil.
Fernando Fernandez-LlimosResearch Institute for Medicines (iMed.ULisboa), Department of Social Pharmacy, Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal.ORCID http://orcid.org/0000-0002-8529-9595
Roberto PontaroloDepartment of Pharmacy, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, Curitiba, Paraná, Brazil.
Astrid WiensDepartment of Pharmacy, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, Curitiba, Paraná, Brazil. astrid@ufpr.br.
Universidade Federal do Paraná · BRUniversity of Lisbon · PT

Funding

Brazilian National Council of Scientific and Technological Research 14/2014 - 442095/2014-7
6 · The paper itself

Abstract

purposeAlthough randomized controlled trials (RCTs) are the gold standard for the assessment of clinical outcomes, long-term extension trials (LTEs) and observational cohorts may help generate evidence. Our goal was to compare the discontinuation rates of abatacept, rituximab, and tocilizumab in rheumatoid arthritis (RA) reported in different study designs.

methodsA systematic review was conducted with searches in PubMed, Scopus, and the Cochrane Library, plus a manual search, for RCTs, LTEs, and observational cohorts reporting discontinuation rates by any of three causes (all-cause, inefficacy, adverse events). Meta-analyses with sensitivity analyses and meta-regressions were conducted.

resultsOf the 111 studies included, 74 were RCTs (n = 55) or LTEs (n = 17) reporting data on abatacept (n = 33), rituximab (n = 10), and tocilizumab (n = 31) and 37 were observational cohort studies (abatacept = 11, rituximab = 8, tocilizumab = 18). The follow-up duration did not differ among the study designs. Discontinuation rates were similar among the drugs but varied among the study designs. Discontinuation rates were significantly higher in cohort studies than those in interventional studies for the three drugs. Sensitivity analyses could not identify patient characteristics associated with these differences. Meta-regression analyses demonstrated no correlation between study follow-up duration and discontinuation rates.

conclusionsThe discontinuation rates reported for non-anti-TNF drugs varied relative to the study design in which they were investigated. Regulatory agencies, price-setting entities, and evidence-gathering researchers should consider the effect of the real-life environment in their decisions and conclusions.

Indexed as

Research DesignAbataceptAntibodies, Monoclonal, HumanizedAntirheumatic AgentsArthritis, RheumatoidHumansRandomized Controlled Trials as TopicRituximabAbataceptAntibodies, Monoclonal, HumanizedAntirheumatic AgentsRituximabtocilizumabEvidence-based medicineMedication AdherenceRheumatoid arthritisStatistics and study design

Identifiers

PMID30022333
OpenAlexW2884792793

What Socratic holds

Textmetadata
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.