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Comparative effectiveness of cycling of tumor necrosis factor-${alpha}$ (TNF-${alpha}$) inhibitors versus switching to non-TNF biologics in rheumatoid arthritis patients with inadequate response to TNF-${alpha}$ inhibitor using a Bayesian approach
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  • Comparative effectiveness of cycling of tumor necrosis factor-${alpha}$ (TNF-${alpha}$) inhibitors versus switching to non-TNF biologics in rheumatoid arthritis patients with inadequate response to TNF-${alpha}$ inhibitor using a Bayesian approach
  • Comparative effectiveness of cycling of tumor necrosis factor-${alpha}$ (TNF-${alpha}$) inhibitors versus switching to non-TNF biologics in rheumatoid arthritis patients with inadequate response to TNF-${alpha}$ inhibitor using a Bayesian approach
저자명
Kim. Hye-Lin,Lee. Min-Young,Park. Sun-Young,Park. Sun-Kyeong,Byun. Ji-Hye,Kwon. Sunhong,Lee. Eui-Kyung
간행물명
Archives of pharmacal research : a publication of the Pharmaceutical Society of Korea
권/호정보
2014년|37권 5호|pp.662-670 (9 pages)
발행정보
대한약학회
파일정보
정기간행물|ENG|
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
서지반출

기타언어초록

Alternative tumor necrosis factor-${alpha}$ (TNF-${alpha}$) inhibitors and non-TNF biologics are available as treatment options for rheumatoid arthritis patients who exhibit inadequate response to TNF-${alpha}$ inhibitor (TNF-IR patients). These agents have considerable efficacy compared with placebo, but head-to-head comparisons among these agents have not been performed. The objective of this study was to use Bayesian approach to compare the effectiveness of cycling TNF-${alpha}$ inhibitors versus switching to non-TNF biologics in TNF-IR patients. A systematic review was conducted using MEDLINE and Cochrane library. Key endpoints were the American College of Rheumatology (ACR) responses of 20/50/70 and the health assessment questionnaire (HAQ) score change at six months. Bayesian outcomes were calculated as the probability that OR is greater than one and HAQ score change difference is less than zero. Compared with TNF-${alpha}$ inhibitors, non-TNF biologics were associated with higher ACR response rates; in ACR20, the OR was 1.639 for abatacept [P(OR>1) = 90.7 %], 1.871 for rituximab [P(OR>1) = 96.2 %] and 3.52 for tocilizumab [P(OR>1) = 99.9 %]. Similar trends were shown in the HAQ change comparison; the median differences (MD) were -0.259 for abatacept [P(MD<0) = 100 %], -0.160 for rituximab [P(MD) = 98.2 %], and -0.200 for tocilizumab [P(MD) = 99.3 %]. In conclusion, switching to non-TNF biologics was more effective than cycling TNF-${alpha}$ inhibitor in TNF-IR patients.