Treatment modifying factors of biologics for psoriatic arthritis: a systematic review and Bayesian meta-regression

Eric Druyts, Jacqueline B. Palmer, Chakrapani Balijepalli, Keith Chan, Mir Sohail Fazeli, Vivian Herrera, Jeroen P. Jansen, Jay J.H. Park, Steve Kanters, Andreas Reimold

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

OBJECTIVES: The aim of this study was to explore factors that modify treatment effects of non-conventional biologics versus placebo in patients with psoriatic arthritis.

METHODS: A systematic literature review and meta-regression was conducted. The biologics included etanercept, infliximab, adalimumab, golimumab, certolizumab, ustekinumab, tocilizumab, anakinra, abatacept, rituximab, and secukinumab. Outcomes included American College of Rheumatology (ACR) 20 and 50, Psoriasis Area Severity Index (PASI) 75, and 36-Item Short Form Health Survey (SF-36) Physical and Mental Component Summaries (PCS and MCS).

RESULTS: Twelve RCTs were eligible for meta-regression. Treatment effects for ACR-20 at 12 weeks were higher in trials with longer disease durations (OR=2.94), and lower in trials enrolling older patients (OR=0.48), and those recently published (OR=0.49). Treatment effects for ACR-50 at 12 weeks were higher in trials with more males (OR=2.27), but lower in trials with high prior anti-TNF use (OR=0.28) and recently published trials (OR=0.37). For PASI-75, trials with more male patients (24 weeks: OR=2.56), and with higher swollen and tender joint counts (12 weeks: OR=8.33; 24 weeks: OR=14.44) showed higher treatment effects, and trials with high prior anti-TNF use had lower effects (OR=0.41). Treatment effects for SF-36 PCS at 24 weeks were higher in trials with longer psoriasis disease durations (OR=2.95) and PsA disease durations (OR=4.76), and those published earlier (OR=4.19).

CONCLUSIONS: Our analyses show that differences in baseline characteristics may explain some of the differences in response to biologics versus placebo across different trials. Accounting for these factors in future studies will likely be important.

Original languageEnglish (US)
Pages (from-to)681-688
Number of pages8
JournalClinical and Experimental Rheumatology
Volume35
Issue number4
StatePublished - Jul 1 2017

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Psoriatic Arthritis
Biological Factors
Biological Products
Psoriasis
Rheumatology
Placebos
Interleukin 1 Receptor Antagonist Protein
Therapeutics
Health Surveys
Joints

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

Cite this

Treatment modifying factors of biologics for psoriatic arthritis : a systematic review and Bayesian meta-regression. / Druyts, Eric; Palmer, Jacqueline B.; Balijepalli, Chakrapani; Chan, Keith; Fazeli, Mir Sohail; Herrera, Vivian; Jansen, Jeroen P.; Park, Jay J.H.; Kanters, Steve; Reimold, Andreas.

In: Clinical and Experimental Rheumatology, Vol. 35, No. 4, 01.07.2017, p. 681-688.

Research output: Contribution to journalArticle

Druyts, E, Palmer, JB, Balijepalli, C, Chan, K, Fazeli, MS, Herrera, V, Jansen, JP, Park, JJH, Kanters, S & Reimold, A 2017, 'Treatment modifying factors of biologics for psoriatic arthritis: a systematic review and Bayesian meta-regression', Clinical and Experimental Rheumatology, vol. 35, no. 4, pp. 681-688.
Druyts, Eric ; Palmer, Jacqueline B. ; Balijepalli, Chakrapani ; Chan, Keith ; Fazeli, Mir Sohail ; Herrera, Vivian ; Jansen, Jeroen P. ; Park, Jay J.H. ; Kanters, Steve ; Reimold, Andreas. / Treatment modifying factors of biologics for psoriatic arthritis : a systematic review and Bayesian meta-regression. In: Clinical and Experimental Rheumatology. 2017 ; Vol. 35, No. 4. pp. 681-688.
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AU - Chan, Keith

AU - Fazeli, Mir Sohail

AU - Herrera, Vivian

AU - Jansen, Jeroen P.

AU - Park, Jay J.H.

AU - Kanters, Steve

AU - Reimold, Andreas

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N2 - OBJECTIVES: The aim of this study was to explore factors that modify treatment effects of non-conventional biologics versus placebo in patients with psoriatic arthritis.METHODS: A systematic literature review and meta-regression was conducted. The biologics included etanercept, infliximab, adalimumab, golimumab, certolizumab, ustekinumab, tocilizumab, anakinra, abatacept, rituximab, and secukinumab. Outcomes included American College of Rheumatology (ACR) 20 and 50, Psoriasis Area Severity Index (PASI) 75, and 36-Item Short Form Health Survey (SF-36) Physical and Mental Component Summaries (PCS and MCS).RESULTS: Twelve RCTs were eligible for meta-regression. Treatment effects for ACR-20 at 12 weeks were higher in trials with longer disease durations (OR=2.94), and lower in trials enrolling older patients (OR=0.48), and those recently published (OR=0.49). Treatment effects for ACR-50 at 12 weeks were higher in trials with more males (OR=2.27), but lower in trials with high prior anti-TNF use (OR=0.28) and recently published trials (OR=0.37). For PASI-75, trials with more male patients (24 weeks: OR=2.56), and with higher swollen and tender joint counts (12 weeks: OR=8.33; 24 weeks: OR=14.44) showed higher treatment effects, and trials with high prior anti-TNF use had lower effects (OR=0.41). Treatment effects for SF-36 PCS at 24 weeks were higher in trials with longer psoriasis disease durations (OR=2.95) and PsA disease durations (OR=4.76), and those published earlier (OR=4.19).CONCLUSIONS: Our analyses show that differences in baseline characteristics may explain some of the differences in response to biologics versus placebo across different trials. Accounting for these factors in future studies will likely be important.

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