SynthesisRheumatology (Oxford, England)2010
The effectiveness of anti-TNF-alpha therapies when used sequentially in rheumatoid arthritis patients: a systematic review and meta-analysis.
Synthesis in Rheumatology (Oxford, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Quantitative Evidence Synthesis Methods for the Assessment of the Effectiveness of Treatment Sequences for Clinical and Economic Decision Making: A Review and Taxonomy of Simplifying Assumptions.PharmacoEconomics · 2021Pooled it
- Real-world effectiveness of anti-TNF switching in psoriatic arthritis: a systematic review of the literature.Clinical rheumatology · 2016Pooled it
- Multivariate meta-analysis of mixed outcomes: a Bayesian approach.Statistics in medicine · 2013Pooled it
- Identification of heterogenous treatment response trajectories to anti-IL6 receptor treatment in rheumatoid arthritis.Scientific reports · 2020Trial
- Trial
- Hepatobiliary disorders associated with TNF-α inhibitors: a pharmacovigilance analysis of FAERS and JADER.Frontiers in immunology · 2025Article
- Therapeutic Antibodies in Medicine.Molecules (Basel, Switzerland) · 2023Review
- A Real-World Claims Database Study Assessing Long-Term Persistence with Golimumab Treatment in Patients with Rheumatoid Arthritis in Japan.Rheumatology and therapy · 2023Article
- Biosimilar medicines uptake: The role of the clinical pharmacist.Exploratory research in clinical and social pharmacy · 2021Article
- Switching of biological therapies in Brazilian patients with rheumatoid arthritis.Future science OA · 2019Article
- Economic Burden of Patients with Inadequate Response to Targeted Immunomodulators for Rheumatoid Arthritis.Journal of managed care & specialty pharmacy · 2018Article
- Factors influencing the use of biologic therapy and adoption of treat-to-target recommendations in current European rheumatology practice.Patient preference and adherence · 2018Article
- Discontinuation of Biologic Therapy in Rheumatoid Arthritis: Analysis from the Corrona RA Registry.Rheumatology and therapy · 2017Article
- A novel indole compound MA-35 attenuates renal fibrosis by inhibiting both TNF-α and TGF-βScientific reports · 2017Article
- Selective Inhibition of Membrane Type 1 Matrix Metalloproteinase Abrogates Progression of Experimental Inflammatory Arthritis: Synergy With Tumor Necrosis Factor Blockade.Arthritis & rheumatology (Hoboken, N.J.) · 2016Article
- Consensus Decision Models for Biologics in Rheumatoid and Psoriatic Arthritis: Recommendations of a Multidisciplinary Working Party.Rheumatology and therapy · 2015Article
- Suppression of Peripheral Pain by Blockade of Voltage-Gated Calcium 2.2 Channels in Nociceptors Induces RANKL and Impairs Recovery From Inflammatory Arthritis in a Mouse Model.Arthritis & rheumatology (Hoboken, N.J.) · 2015Article
- Effects of anti-TNF alpha drugs on disability in patients with rheumatoid arthritis: long-term real-life data from the Lorhen Registry.BioMed research international · 2014Article
- Development of low blood glucose readings in nine non-diabetic patients treated with tumor necrosis factor-alpha inhibitors: a case series.Journal of medical case reports · 2012Article
- Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo systematically review and meta-analyse evidence on the effectiveness of the TNF-α inhibitors when used sequentially.
methodsSystematic review of comparative and single-arm observational studies. Data were synthesized using random-effects meta-analysis. Treatment effects were estimated using four outcome measures from the included studies: European League Against Rheumatism (EULAR) and ACR20 response rates and mean improvement in disease activity score-28 (DAS-20) and HAQ. The effect of other factors was explored via meta-regression and sub-group analyses.
resultsTwenty studies comprising 2705 patients were included in the analysis. All studies were observational and most had no control group. Therefore, our primary analysis considered patient changes from baseline. The mean percentage of ACR20 responders was 60.8% (95% CI 53.8, 67.4), EULAR responders 70.5% (95% CI 63.7, 76.6), mean overall improvement in DAS-28 scores was 1.53 (95% CI 1.25, 1.80) and in HAQ scores was 0.25 (95% CI 0.11, 0.40). Four studies made comparisons with patients who received TNF-α inhibitors for the first time. Response rates associated with sequential TNF-α inhibitor treatment were lower than for first-time use.
conclusionsSequential TNF-α inhibitor use is likely to lead to treatment benefit in terms of the signs and symptoms of disease and physical function. There is also some evidence to suggest that the probability of achieving a response is lower, and the average magnitude of response is lower than the first use. Further evidence from randomized controlled trials is required to confirm and further quantify the role specific anti-TNF-α agents have when used sequentially.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.