Rheumatoid arthritis

Monotreatment With Conventional Antirheumatic Drugs or Glucocorticoids in Rheumatoid Arthritis: A Network Meta-Analysis

JAMA Netw OpenPublished Systematic review and network meta-analysis of randomised trials

Pooled result · Tender joint count reductionResult — go to the resultReduction 5.18 joints 95% CrI 4.07–6.28

Authors' conclusion

This study's results support the present role of methotrexate as the primary reference conventional synthetic disease-modifying antirheumatic drug.

Study context

Population
Patients with RA in RCTs of mono-csDMARDs, GC, placebo or nonactive treatment (mean RA duration 79 months; mean disease activity score 6.3)
Participants
13,260 patients132 RCTs
Comparison
Mono-csDMARDs or GC vs placebo or nonactive treatment, and vs MTX
Outcome
Tender joint count, absolute change adjusted for baseline disease activity
Methodological detailsrandom effect model, Cochrane RoB 2, PRISMA, protocol registered before data recording
  • Random effect model
  • Cochrane RoB 2
  • PRISMA
  • Protocol registered before data recording

Pooled result

Tender joint count reduction

Reduction

5.18 joints

95% CrI 4.07–6.28

As reported in the abstract

Further pooled results

OutcomeDifference (joints) (95% CrI)
Tender joint count vs MTXGCvs Oral MTXCrI−2.54 (−5.16 to 0.08)
Tender joint count vs MTXCyclophosphamidevs Oral MTXCrI6.08 (0.44–11.66)

Tender joint count vs MTX

Remaining drugs except cyclophosphamide associated with similar or lower tender joint counts vs MTX

Original publication

Monotreatment With Conventional Antirheumatic Drugs or Glucocorticoids in Rheumatoid Arthritis: A Network Meta-Analysis. JAMA Netw Open. Published 2 October 2023. doi:10.1001/jamanetworkopen.2023.35950

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