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TNF-α inhibitors on par with novel biologics for resolution of dactylitis, enthesitis

12 Jan 2020

Tumour necrosis factor-α (TNF-α) inhibitors infliximab, golimumab and adalimumab are as effective as novel biologic agents ustekinumab, secukinumab and ixekizumab in the treatment of dactylitis and enthesitis, results of a systematic review and meta-analysis have shown.

The investigators performed a systematic literature search and a pooled meta-analysis of randomized controlled trials (RCTs) with TNF-α inhibitors, anti–interleukin (IL)-12/23 (ustekinumab) and anti–IL-17 (secukinumab, ixekizumab) using the random-effects model. They also assessed bias using the Cochrane risk-of-bias tool.

Eighteen RCTs including 6,981 patients were eligible for the pooled analysis. Both TNF-α inhibitors and novel biologic agents effectively resolved dactylitis at week 24 (pooled risk ratio [RR] vs placebo, 2.57, 95 percent confidence interval [CI], 1.36–4.84 and RR, 1.88, 95 percent CI, 1.33–2.65, respectively). TNF-α inhibitors (RR, 1.93, 95 percent CI, 1.33–2.79) and novel biologics (RR, 1.95, 95 percent CI, 1.60–2.38) were also effective in the resolution of enthesitis at week 24.

Both biologic categories showed overlapping ranges of American College of Rheumatology 20 responses (TNF-α inhibitors: RR, 2.23, 95 percent CI, 1.60–3.11; pooled IL-12/23 and -17: RR, 2.30, 95 percent CI, 1.94–2.72) and similar quality of life improvement scores, with mean Health Assessment Questionnaire–Disability Index score changes of –0.29 (95 percent CI, –0.39 to –0.19) and –0.26 (95 percent CI, –0.31 to –0.22), respectively.

“Biologic agents with different mechanisms of action showed efficacy in RCTs in the treatment of psoriatic arthritis,” the investigators said.

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Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
Pearl Toh, 6 days ago
Obeticholic acid significantly improves fibrosis and disease activity in patients with nonalcoholic steatohepatitis (NASH), a chronic liver disease currently with no approved therapy, according to an interim analysis of the landmark REGENERATE* study.
12 Jan 2020
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.