Drug Therapy for Rheumatoid Arthritis in Adults
Comparative Adverse Effects of Biologic DMARDs (2 of 3)
The systematic review investigated adverse effects associated with biologic disease-modifying anti-rheumatic drugs (DMARDs) in treatment of rheumatoid arthritis. Mixed treatment comparison analysis of data from placebo-controlled trials of biologic DMARDs (43 trials, 19,413 patients) provided the basis for the following conclusions:
- Certolizumab pegol, etanercept, and rituximab have more favorable overall treatment withdrawal profiles than other biologic DMARDs. The strength of evidence for this finding is low.
- Withdrawal from treatment due to adverse events is more likely with certolizumab pegol and infliximab than with etanercept or rituximab. The strength of evidence for this finding is low.
- Withdrawals from treatment due to injection site reactions are more likely with anakinra, and infliximab is associated with a higher rate of infusion reactions. The strength of evidence for these findings is low.
Keywords: Rheumatoid arthritis | RA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | biologic DMARD | mixed treatment comparison | certolizumab pegol | etanercept | rituximab | infliximab | etanercept | anakinra | infusion reaction | injection site reaction
- Donahue KE, Jonas D, Hansen RA, et al. Drug Therapy for Rheumatoid Arthritis in Adults: An Update. Comparative Effectiveness Review No. 55 (Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2007-10056-I). Rockville, MD: Agency for Healthcare Research and Quality; April 2012. AHRQ Publication No. 12-EHC025-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsra.cfm.
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