Efficacy and safety of TNF-? inhibitors for active ankylosing spondylitis patients: Multiple treatment comparisons in a network meta-analysis.

ABSTRACT: Ankylosing spondylitis (AS) is an inflammatory rheumatic disease with impact on axial skeleton, peripheral joints and enthuses, and it may result in severe disabilities of those parts. Tumor necrosis factor-? (TNF-?) inhibitors are considered as an effective treatment for patients with active AS. In this study, we conducted a network meta-analysis to compare the clinical outcomes of active AS patients treated with TNF-? inhibitors. Randomized controlled trials (RCTs) evaluating the efficacy and safety of TNF-? inhibitors were retrieved in literature search and selected for meta-analysis. Changes in ASAS20 response, ASAS40 response and BASDAI 50% response were regarded as efficacy outcomes; serious adverse events (SAE) and all cause withdrawals were regarded as safety outcomes. Both traditional pairwise meta-analysis and network meta-analysis were performed. The results showed that adalimumab and infliximab had better clinical outcomes. Infliximab consistently appeared to be the most effective TNF-? inhibitors with a high risk of adverse events for patients with active AS; meanwhile, adalimumab ranked highest with respect to adverse effects with efficacy secondary to infliximab. As a result, we were unable to conclude the optimal TNF-? inhibitor and this issue should be solved by future researchers.

SUBMITTER: Liu W 

PROVIDER: S-EPMC5036083 | biostudies-other | 2016 Sep

REPOSITORIES: biostudies-other