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Effect of biologic disease-modifying anti-rheumatic drugs targeting remission in axial spondyloarthritis : systematic review and meta-analysis

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dc.contributor.authorMachado, Ana Rita
dc.contributor.authorRodrigues Manica, Santiago
dc.contributor.authorSilva, Joana Leite
dc.contributor.authorAlho, Irina
dc.contributor.authorCoelho, Constança
dc.contributor.authorDuarte, Joana
dc.contributor.authorFlorêncio, Cláudia
dc.contributor.authorPimentel-Santos, Fernando M.
dc.contributor.authorTavares-Costa, José
dc.contributor.authorVieira de Sousa, Elsa Cristina
dc.date.accessioned2021-03-01T17:28:13Z
dc.date.available2021-03-01T17:28:13Z
dc.date.issued2020
dc.description© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.pt_PT
dc.description.abstractObjectives: To assess the efficacy of biologic DMARDs (bDMARDs) in achieving Assessment of Spondyloarthritis International Society partial remission (ASAS-PR) and/or Ankylosing Spondylitis Disease Activity Score inactive disease (ASDAS-ID), as remission-like surrogates, in axial SpA (axSpA). Methods: Data from randomized controlled trials (RCTs), including long-term extensions, were included. A systematic literature review was performed using the MEDLINE database (first search May 2018, updated February 2020) and PICO criteria according to Patients—adults with radiographic or non-radiographic axSpA; Intervention—any bDMARD; Comparator—placebo and/or any different drug; Outcomes—ASAS-PR and/or ASDAS-ID as primary or secondary endpoints. Meta-analysis was performed after assessment of the homogeneity of study designs, populations and outcomes. Results: After screening 155 references, a total of 22 RCTs and 28 long-term extensions were retrieved. ASAS-PR was the dominant remission-like definition used. Concerning TNF inhibitors, 14/17 RCTs provided evidence of efficacy in reaching remission at different time points: 12, 16, 24 and 28 weeks (ASAS-PR in 16–62% of patients and ASDAS-ID in 24–40% of patients). With a limited number of studies available, IL-17A inhibitors exhibited remission rates of 15–21% for ASAS-PR and 11–16% for ASDAS-ID at week 16. A meta-analysis regarding ASAS-PR was performed considering RCTs with a similar duration (12, 16 or 24 weeks). The relative risk for achieving remission was 3.864 (95% CI 2.937, 5.085). Conclusion: bDMARDs have a clear impact in axSpA remission evaluated by ASAS-PR. Nevertheless, these data show an unmet need for improved reporting of remission-like outcomes.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRheumatology, Vol. 59, Issue 11, Nov. 2020, pp. 3158–3171pt_PT
dc.identifier.doi10.1093/rheumatology/keaa268pt_PT
dc.identifier.eissn1462-0332
dc.identifier.issn1462-0324
dc.identifier.urihttp://hdl.handle.net/10451/46593
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.relation.publisherversionhttps://academic.oup.com/rheumatologypt_PT
dc.subjectAxial spondyloarthritispt_PT
dc.subjectBiologic disease-modifying anti-rheumatic drugspt_PT
dc.subjectRemissionpt_PT
dc.subjectAssessment of Spondyloarthritis International Society partial remissionpt_PT
dc.subjectAnkylosing Spondylitis Disease Activity Score inactive diseasept_PT
dc.titleEffect of biologic disease-modifying anti-rheumatic drugs targeting remission in axial spondyloarthritis : systematic review and meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage3171pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage3158pt_PT
oaire.citation.titleRheumatologypt_PT
oaire.citation.volume59pt_PT
person.familyNameMachado
person.familyNameCoelho
person.familyNameVieira de Sousa
person.givenNameAna Rita
person.givenNameConstança
person.givenNameElsa Cristina
person.identifier426629
person.identifier.ciencia-id7515-8385-064B
person.identifier.ciencia-id1519-509A-8B89
person.identifier.orcid0000-0003-0600-876X
person.identifier.orcid0000-0002-5331-2257
person.identifier.orcid0000-0002-7170-8802
person.identifier.scopus-author-id7005608345
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication47fa1e23-6318-4e58-a2b8-addce384ea94
relation.isAuthorOfPublication6b90db77-8f9c-48a9-a91e-6410d4b862e6
relation.isAuthorOfPublication8b9873ad-2667-48e6-aece-a73dec6a8296
relation.isAuthorOfPublication.latestForDiscovery6b90db77-8f9c-48a9-a91e-6410d4b862e6

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