Comparative effectiveness of treatments for rheumatoid arthritis in clinical practice: A systematic review
Authors' conclusion
This systematic review summarizing real-world evidence from a very large number of global studies found there are many effective options for the treatment of RA, but relatively less evidence to support the use of any one b/tsDMARD or drug class over another.
Study context
- Population
- Adults with rheumatoid arthritis (RA) treated with b/tsDMARDs in real-world clinical practice68 selected, 1 excluded
- Comparison
- b/tsDMARDs compared with each other in clinical practice
- Outcome
- Comparative effectiveness on American College of Rheumatology (ACR)-recommended disease activity measures, functional status and patient-reported outcomes
Methodological detailsno meta-analysis (methodological heterogeneity), ROBINS-I risk of bias, 1283 records screened; 68 selected for data extraction, 1 excluded for critical risk of bias, Most studies multicentre observational cohort/registry studies (n = 60)
- No meta-analysis (methodological heterogeneity)
- ROBINS-I risk of bias
- 1283 records screened; 68 selected for data extraction, 1 excluded for critical risk of bias
- Most studies multicentre observational cohort/registry studies (n = 60)
Pooled result
As reported in the abstract
Clinical effectiveness of b/tsDMARDs
- No evident differences between b/tsDMARDs in clinical effectiveness
Further pooled results
Most common outcomes used in clinical practice
- Disease Activity Score in 28 joints (studies)
- 46
- CDAI (studies)
- 37
- HAQ-DI (studies)
- 32
- Regional differences identified
Most common comparison: Tumor necrosis factor inhibitors (TNFis) vs non-TNFi bDMARDs
- Studies
- 35
Original publication
Comparative effectiveness of treatments for rheumatoid arthritis in clinical practice: A systematic review. Semin Arthritis Rheum. Published 6 August 2023. doi:10.
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