The impact of autoantibodies on the efficacy of biological disease-modifying anti-rheumatic drugs in rheumatoid arthritis: meta-analysis of randomized controlled trials
Authors' conclusion
The effect of bDMARDs is generally comparable in patients with and without RF/ACPA, regardless of the patient population, the mechanism of action or individual drug used.
Study context
- Population
- RCTs of bDMARDs including both autoantibody-positive (≤80% of total population) and -negative RA patients; subgroups csDMARD-naive, csDMARD-IR and TNFi-IR28 RCTs
- Comparison
- Seropositive vs seronegative RA patients: efficacy of bDMARDs
- Outcome
- Efficacy of bDMARDs (ACR20 RRR, seropositive vs seronegative)
- Follow-up
- 6 months
Methodological detailsrandom effect meta-analyses
- Random effect meta-analyses
Pooled result
As reported in the abstract
Pooled 6-month ACR20 RRR, csDMARD-naive; seropositivity not associated with a better response to bDMARDs
1.02
0.88–1.18
Further pooled results
ACR20, pooled RRR, seropositive vs seronegative, csDMARD-IR · 6 months
- Pooled 6-month ACR20 RRR, csDMARD-IR; seropositivity not associated with a better response to bDMARDs
- 1.09 (0.90-1.32)
- 14 studies pooled
ACR20, RRR, seropositive vs seronegative, TNFi-IR · 6 months
- 6-month ACR20 RRR, TNFi-IR, favoring efficacy in seropositive patients
- 2.28 (1.31-3.95)
- Based on three trials
Other outcomes, csDMARD-naive and csDMARD-IR
- No difference between groups
Other outcomes, TNFi-IR
- Mostly no significant difference between the groups
By mode of action (TNFi, non-TNFi) and individual bDMARDs
- Efficacy comparable between RF-positive and RF-negative patients
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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