Evidence map›Paper›PMID 25388909›Full record

SynthesisClinical drug investigation2015

Indirect comparison between subcutaneous biologic agents in ankylosing spondylitis.

Alberto Migliore, Emanuele Bizzi, Mauro Bernardi, Andrea Picchianti Diamanti, Bruno Laganà, Lea Petrella

Abstract readComparative StudyMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Clinical drug investigation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Alberto MiglioreDepartment of Rheumatology, Rheumatology Unit, S.Pietro Fatebenefratelli Hospital, Via cassia 600, 00189, Rome, Italy.
Emanuele Bizzi
Mauro Bernardi
Andrea Picchianti Diamanti
Bruno Laganà
Lea Petrella
Sapienza University of Rome · ITFatebenefratelli Hospital · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveThere are four efficacious subcutaneous anti-tumor necrosis factor alpha (TNF-alpha) agents used for the therapy of ankylosing spondilitis (AS), but apparently little or no differences in their effectiveness was proven. By this study, we aimed to compare Assessment in Ankylosing Spondylitis Response Criteria 20 response patterns (ASAS20) between subcutaneous approved biological agents in patients affected by ankylosing spondylitis by means of a mixed treatment comparison of different randomized controlled trials (RCTs) on the efficacy of biological therapies.

methodsA search in scientific literature was performed to identify the most complete collection of RCTs available on the selected topic. Similarly designed double-blind, randomized, placebo-controlled trials investigating the efficacy of the subcutaneous and approved TNF-alpha inhibitors such as etanercept, certolizumab pegol, golimumab and adalimumab in the treatment of ankylosing spondylitis patients were identified. The endpoint of interest was ASAS20 response criterium at 12 weeks. Results were analysed simultaneously using Bayesian mixed treatment comparison techniques. Results were expressed as odds ratio (OR) of positive ASAS20 response and associated 95 % credible intervals (CrIs). The probability of being the best treatment was also reported.

resultsOnly five RCTs matched the inclusion criteria for consequent data extraction and analysis. Mixed treatment comparison of data from such RCTs demonstrated that all subcutaneous anti-TNF-alpha agents are more effective in inducing an ASAS20 response than placebo. Data from 24 weeks' follow-up were not taken into account as early escape granted in some of the studies made results at 24 weeks unmatchable. In our analysis, golimumab proved to be the drug that more probably represents the best choice for achieving ASAS20 response at 12 weeks, although no differences were observed when comparing directly every single subcutaneous anti-TNF-alpha agent against another.

conclusionsEven if the mixed treatment comparisons between adalimumab, golimumab, certolizumab pegol and etanercept did not show a statistically significant difference, this analysis, based on data from only five RCTs, suggests that golimumab, compared to placebo, may be the drug that provides the highest probability of achieving ASAS20 response in AS patients naive to biologic treatments at 12 weeks.

Indexed as

Biological FactorsHumansInjections, SubcutaneousRandomized Controlled Trials as TopicSpondylitis, AnkylosingTreatment OutcomeBiological Factors

Identifiers

PMID25388909
OpenAlexW2013163650

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.