AI Article Synopsis
- The article aims to update evidence on the effectiveness and safety of DMARDs for rheumatoid arthritis (RA) to inform the 2024 guidelines by the Japan College of Rheumatology.
- A thorough search included randomized controlled trials published until June 2022, with independent reviews and meta-analyses conducted on 15 clinical questions related to RA treatment.
- Key findings indicate that subcutaneous methotrexate is as effective as oral, ozoralizumab with methotrexate is more effective than a placebo, and biosimilars are equally effective as their original counterparts in treating RA.
Article Abstract
Objectives: The aim of this article is to update evidence on the efficacy and safety of disease-modifying antirheumatic drugs (DMARDs) and provide information to the taskforce for the 2024 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis (RA).
Methods: We searched various databases for randomised controlled trials on RA published until June 2022, with no language restriction. For each of the 15 clinical questions, two independent reviewers screened the articles, evaluated the core outcomes, and performed meta-analyses.
Results: Subcutaneous injection of methotrexate (MTX) showed similar efficacy to oral MTX in MTX-naïve RA patients. Ozoralizumab combined with MTX improved drug efficacy compared to the placebo in RA patients with inadequate response (IR) to conventional synthetic DMARD (csDMARD). Rituximab with and without concomitant csDMARDs showed similar efficacy to other biological DMARDs (bDMARDs) in bDMARD-IR RA patients. Combined Janus kinase inhibitors and MTX achieved similar clinical responses and equal safety during a 4-year period compared to tumour necrosis factor inhibitors in MTX-IR RA patients. Biosimilars showed efficacy equivalent to that of the original bDMARDs in csDMARD-IR and bDMARD-IR RA patients.
Conclusions: This systematic review provides latest evidence for the 2024 update of the Japan College of Rheumatology clinical practice guidelines for RA management.
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| http://dx.doi.org/10.1093/mr/roae049 | DOI Listing |
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