Biologics for rheumatoid arthritis work, but which is best?

Oct 07, 2009

More studies that directly compare the effectiveness of different biologic drugs for rheumatoid arthritis (RA) are needed, say Cochrane Researchers. The researchers reviewed all previous Cochrane Systematic Reviews assessing the effectiveness of biologic disease-modifying drugs for treatment of RA and found that although all were very effective, there was little data on direct comparisons between the drugs that could help doctors decide which to prescribe.

RA is an autoimmune disease that affects up to 1 in 100 people in Western countries. Patients experience chronic pain and inflammation as a result of the body's own immune system attacking the lining of the joints. In recent years, biologic disease-modifying anti-rheumatic drugs (DMARDs) have been introduced that can help to modify this irregular and improve symptoms of the disease. Although these drugs may have fewer side effects than traditional DMARDs such as methotrexate, they are more expensive.

The six previous reviews considered by the researchers used two measures to make indirect comparisons between different biologic drugs. The first was doctor or patient assessment of symptoms including the number of swollen joints. For adalimumab, etanercept and rituximab, an increase of at least 40% was seen in the number of people experiencing improved symptoms, when the drugs were compared to placebos. Anakinra was the least effective at just 6% improvement compared to placebos. The second measure was the number of people who dropped out of studies due to adverse effects. Less than 10% dropped out in most cases, however, etanercept, abatacept and seemed to be responsible for the fewest withdrawals, showing little difference to the numbers dropping out when taking placebos.

"Doctors are faced with a difficult dilemma when choosing biologics to prescribe to RA patients. Although anakinra seemed less effective in the trials we looked at, we did not have any data from direct comparisons between different drugs," says lead researcher Jasvinder Singh, who is based at the Minneapolis Veterans Affairs Medical Center in Minneapolis in the US.

"We believe that direct head-to-head comparisons of biologic drugs in patients suffering from RA are needed. These trials should examine efficacy and safety at different stages and severity levels of the disease, as well as prior treatment with other drugs."

Source: Wiley (news : web)

Explore further: Malaysia reports first Asian death from MERS virus

add to favorites email to friend print save as pdf

Related Stories

Latest rheumatoid arthritis drugs compared

Apr 17, 2008

Findings published today in the open access journal BMC Musculoskeletal Disorders shows that the latest class of drugs used to treat rheumatoid arthritis (RA) are better than standard anti-inflammatories.

New biologic drug is effective against rheumatoid arthritis

Oct 06, 2009

Abatacept, a member of a new class of drug that targets immune cells to treat rheumatoid arthritis (RA), is effective against RA, according to a new Cochrane Systematic Review. The review examines recent trials to assess ...

New guidelines for treating rheumatoid arthritis

Jul 22, 2008

Proven combinations of medicines and the introduction of new anti-arthritis drugs have significantly improved the treatment of rheumatoid arthritis (RA), according to guidelines issued by the American College of Rheumatology ...

Recommended for you

Malaysia reports first Asian death from MERS virus

1 hour ago

A Malaysian man who went on a pilgrimage to Saudi Arabia has become the first death in Asia from Middle East respiratory syndrome, while the Philippines has isolated a health worker who tested positive for the deadly coronavirus.

Philippines quarantines man over MERS fears

2 hours ago

Philippine health authorities said Wednesday they have quarantined a Filipino who arrived from the Middle East because he tested positive for the deadly MERS virus.

Thyroid disease risk varies among blacks, Asians, and whites

20 hours ago

An analysis that included active military personnel finds that the rate of the thyroid disorder Graves disease is more common among blacks and Asian/Pacific Islanders compared with whites, according to a study in the April ...

User comments : 0

More news stories

HIV+ women respond well to HPV vaccine

HIV-positive women respond well to a vaccine against the human papillomavirus (HPV), even when their immune system is struggling, according to newly published results of an international clinical trial. The study's findings ...