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Drug Therapy for Rheumatoid Arthritis in Adults

Slide: 26 of 45

Summary of Benefits: Biologic DMARDs

Considered as a class, for patients with longstanding active rheumatoid arthritis requiring a change in therapy, biologic disease-modifying anti-rheumatic drugs (DMARDs) provide greater symptom response and remission rate than do the oral DMARDs. The strength of evidence for this conclusion is moderate.

Overall, the evidence about functional capacity and quality of life is insufficient to permit estimates of comparative effectiveness.

Considered as a class, for patients with longstanding active disease requiring a change in therapy, biologic DMARDs provide greater symptom response and remission rate than do the oral DMARDs.

Combining two biologic DMARDs (etanercept with abatacept or anakinra) does not add to improvement in disease activity, functional capacity, or symptom response more than one biologic DMARD and increases the risk of serious adverse effects. The strength of evidence for this conclusion is low.

Comparisons across studies of patients whose disease is resistant to methotrexate suggest that there may be clinically observable differences in the efficacy of the biologic DMARDs. Evidence from head-to-head comparisons is too limited to provide guidance for clinical decisionmaking. The strength of evidence for this conclusion is low.