Evidence map›Paper›PMID 37060528›Full record

Observational studyClinical rheumatology2023

Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry.

Anthony Sebba, Clifton O Bingham, Vivian P Bykerk, Stefano Fiore, Kerri Ford, Jud C Janak, Dimitrios A Pappas, Taylor Blachley, Swapna S Dave, Joel M Kremer and 2 more

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Clinical rheumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 24% 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

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Engineering Bispecific Peptides for Precision Immunotherapy and Beyond.International journal of molecular sciences · 2025
    Review
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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

12 authors at 6 institutions in 2 countries.

Anthony SebbaRheumatology, Arthritis Associates, Palm Harbor, FL, USA. anthonysebba@gmail.com.ORCID http://orcid.org/0000-0002-3028-9365
Clifton O BinghamDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-4752-5029
Vivian P BykerkInflammatory Arthritis Center, Hospital for Special Surgery, New York, NY, USA.ORCID http://orcid.org/0000-0002-1219-3845
Stefano FioreMedical Affairs, Sanofi, Bridgewater, NJ, USA.ORCID http://orcid.org/0000-0002-3785-2448
Kerri FordMedical Affairs, Sanofi, Cambridge, MA, USA.
Jud C JanakCorEvitas, LLC, Waltham, MA, USA.
Dimitrios A PappasCorEvitas, LLC, Waltham, MA, USA.ORCID http://orcid.org/0000-0001-8338-027X
Taylor BlachleyCorEvitas, LLC, Waltham, MA, USA.
Swapna S DaveCorEvitas, LLC, Waltham, MA, USA.
Joel M KremerCorEvitas, LLC, Waltham, MA, USA.ORCID http://orcid.org/0000-0001-6674-9901
Miao YuCorEvitas, LLC, Waltham, MA, USA.
Ernest ChoyCREATE Centre, Division of Infection and Immunity, Cardiff University, Wales, UK.ORCID http://orcid.org/0000-0003-4459-8609
Navitas Systems (United States) · USSanofi (United States) · USArthritis and Rheumatism Associates · USCardiff University · GBHospital for Special Surgery · USJohns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRandomized controlled trials (RCTs) in biologic-naïve rheumatoid arthritis (RA) patients with high disease activity and inadequate response/intolerance to methotrexate have shown interleukin-6 (IL-6) receptor inhibitors (IL-6Ri) to be superior to tumor necrosis factor inhibitors (TNFi) as monotherapy. This observational study aimed to compare the effectiveness of TNFi vs IL-6Ri as mono- or combination therapy in biologic/targeted synthetic (b/ts) -experienced RA patients with moderate/high disease activity.

methodsEligible b/ts-experienced patients from the CorEvitas RA registry were categorized as TNFi and IL-6Ri initiators, with subgroups initiating as mono- or combination therapy. Mixed-effects regression models evaluated the impact of treatment on Clinical Disease Activity Index (CDAI), patient-reported outcomes, and disproportionate pain (DP). Unadjusted and covariate-adjusted effects were reported.

resultsPatients initiating IL-6Ri (n = 286) vs TNFi monotherapy (n = 737) were older, had a longer RA history and higher baseline CDAI, and were more likely to initiate as third-line therapy; IL-6Ri (n = 401) vs TNFi (n = 1315) combination therapy initiators had higher baseline CDAI and were more likely to initiate as third-line therapy. No significant differences were noted in the outcomes between TNFi and IL-6Ri initiators (as mono- or combination therapy).

conclusionThis observational study showed no significant differences in outcomes among b/ts-experienced TNFi vs IL-6Ri initiators, as either mono- or combination therapy. These findings were in contrast with the previous RCTs in biologic-naïve patients and could be explained by the differences in the patient characteristics included in this study. Further studies are needed to help understand the reasons for this discrepancy in the real-world b/ts-experienced population.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidBiological ProductsHumansMethotrexateReceptors, Interleukin-6RegistriesSeverity of Illness IndexTreatment OutcomeTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAntirheumatic AgentsBiological ProductsMethotrexateReceptors, Interleukin-6Tumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAntirheumatic agentsBiological therapyInterleukin-6 receptor inhibitorsPatient-reported outcomesRheumatoid arthritisTumor necrosis factor inhibitors

Identifiers

PMID37060528
PMCPMC10345054
OpenAlexW4365810910

What OpenQuestion holds

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LicenceCC BY
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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.