ReviewNature reviews. Rheumatology2013
Biologic agents in rheumatology: unmet issues after 200 trials and $200 billion sales.
Review in Nature reviews. Rheumatology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 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
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Clinical Benefit, Price, and Uptake for Cancer Biosimilars vs Reference Drugs in China: A Systematic Review and Meta-Analysis.JAMA network open · 2023Pooled it
- Comparative effectiveness of biological medicines in rheumatoid arthritis: systematic review and network meta-analysis including aggregate results from reanalysed individual patient data.BMJ (Clinical research ed.) · 2020Pooled it
- Industry sponsorship and research outcome.The Cochrane database of systematic reviews · 2017Pooled it
- Risk of serious infection in biological treatment of patients with rheumatoid arthritis: a systematic review and meta-analysis.Lancet (London, England) · 2015Pooled it
- Tumour necrosis factor inhibitors versus combination intensive therapy with conventional disease modifying anti-rheumatic drugs in established rheumatoid arthritis: TACIT non-inferiority randomised controlled trial.BMJ (Clinical research ed.) · 2015Trial
- A head-to-head comparison of TNF-α inhibitors as the first biologic treatment of rheumatoid arthritis.Rheumatology (Oxford, England) · 2026Observational
- The Impact of Industry Funding on Randomized Controlled Trials of Biologic Therapies.Medicines (Basel, Switzerland) · 2022Review
- Association Between Payments by Pharmaceutical Manufacturers and Prescribing Behavior in Rheumatology.Mayo Clinic proceedings · 2022Article
- Article
- Article
- Drugs for Autoimmune Inflammatory Diseases: From Small Molecule Compounds to Anti-TNF Biologics.Frontiers in pharmacology · 2017Review
- Better prioritization to increase research value and decrease waste.BMC medicine · 2015Article
- Clinical trials: A transparent future for clinical trial reporting.Nature reviews. Rheumatology · 2015Article
- 1,25-Dihydroxyvitamin D3-Conditioned CD11c+ Dendritic Cells are Effective Initiators of CNS Autoimmune Disease.Frontiers in immunology · 2015Article
- Network meta-analysis for comparing treatment effects of multiple interventions: an introduction.Rheumatology international · 2014Review
- Evidence-based de-implementation for contradicted, unproven, and aspiring healthcare practices.Implementation science : IS · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anti-TNF agents and other biologic therapies are widely prescribed for a variety of indications, with total sales that exceed $200 billion to date. In rheumatic diseases, biologic agents have now been studied in more than 200 randomized clinical trials and over 100 subsequent meta-analyses; however, the information obtained does not always meet the needs of patients and clinicians. In this Review, we discuss the current issues concerning the evidence derived from such studies: potential biases favouring positive results; a paucity of head-to-head comparisons between biologically active agents; overwhelming involvement of manufacturer sponsors in trials and in the synthesis of the evidence; the preference for trials with limited follow-up; and the potential for spurious findings on adverse events, leading to endless debates about malignancy risk. We debate the responsibilities of regulatory authorities, the pharmaceutical industry and academia in attempting to solve these shortcomings and challenges. We propose that improvements in the evidence regarding biologic treatments that are continually being added to the therapeutic armamentarium for rheumatic diseases might require revisiting the design and conduct of studies. For example, trials with long-term follow-up that are independent of the pharmaceutical industry, head-to-head comparisons of therapeutic agents and the use of rigorous clinical outcomes should be considered, and public availability of raw data endorsed.
Indexed as
Identifiers
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.