Host: The Japanese Society of Toxicology
Name : The 50th Annual Meeting of the Japanese Society of Toxicology
Date : June 19, 2023 - June 21, 2023
[Background and Objective] Rheumatoid arthritis (RA) is a chronic inflammatory disease. For patients whose treatment effect with methotrexate (MTX) monotherapy is not obvious, it is necessary to use a combination therapy of Disease-modifying antirheumatic drugs (DMARDs) with MTX. Although several kinds of DMARDs are now clinically available, there are few reports which compare safety and efficacy between combination therapies. Therefore, our study compared the safety and efficacy of combination therapy and monotherapy through a Bayesian method of Meta-Analysis.
[Methods] As of October 25, 2020, we extracted the data from randomized clinical trial (RCT) study on the safety and efficacy of MTX combined with biological /targeted synthetic DMARDs for RA from PubMed, EMBASE, CENTRAL, Ichushi Web, and review reports from Pharmaceutical Medical Device Agency (PMDA). The index of efficacy is the intensity of ACR20, which is the standard index for RA to achieve 20% improvement rate formulated by American College of Rheumatology (ACR), and the index of safety is the number of adverse events (AE). We used the Bayesian method for Network Meta-Analysis of the data using the “gemtc” package 1.0-1 of R 4.2.1.
[Results and Discussion] A total of 78 literatures were underwent to Network Meta-Analysis. Results showed higher efficacy of Certolizumab, Infliximab, Sarilumab, Tofacitinib, and Etanercept in combination with MTX. Both Etanercept and Tofacitinib in combination with MTX were relatively safety. From both aspects of the efficacy and the safety, the combination therapy of MTX with Tofacitinib, a targeted synthetic DMARDs, and Etanercept, a biological DMARDs, had relatively high efficacy and safety among DMARDs combination therapies with MTX.
