Spondyloarthritis & psoriatic arthritis
Efficacy and safety of biological DMARDs: a systematic literature review informing the 2022 update of the ASAS-EULAR recommendations for the management of axial spondyloarthritis
Authors' conclusion
New evidence supports the efficacy and safety of TNFi (originators/biosimilars) and IL-17i in r-axSpA and nr-axSpA, while IL-23i failed to show relevant effects.
Study context
- Population
- Patients with axial spondyloarthritis (axSpA) (r-axSpA/nr-axSpA); literature 2016–2021148 publications
- Exposure
- Biological disease-modifying antirheumatic drugs (bDMARDs) in axSpA
- Outcome
- Efficacy of bDMARDs in axSpA
Methodological detailsinforming the 2022 update of the ASAS-EULAR recommendations, randomised controlled trials (RCTs), strategy trials and observational studies (observational only for safety and extra-musculoskeletal manifestations)
- Informing the 2022 update of the ASAS-EULAR recommendations
- RCTs, strategy trials and observational studies (observational only for safety and extra-musculoskeletal manifestations)
Main finding
As reported in the abstract
IL-17i vs placebo, ASAS40 response RR, r-axSpA (n=9 RCTs)
1.3-15.3
IL-17i vs placebo, ASAS40 response RR, nr-axSpA (n=2 RCTs)
1.4-2.1
Observational data: associations, not effects.
Safety
Safety of tumour necrosis factor inhibitor (TNFi) in observational studies
- No new risks identified with TNFi use (data lacking for IL-17i)
Uveitis vs monoclonal TNFi in observational studies
- Secukinumab (n=1 study) associated with increased risk of uveitis
- Etanercept (n=2 studies) associated with increased risk of uveitis
Original publication
Efficacy and safety of biological DMARDs: a systematic literature review informing the 2022 update of the ASAS-EULAR recommendations for the management of axial spondyloarthritis. Ann Rheum Dis. Published 21 October 2022. doi:10.
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