Tumor necrosis factor alpha drugs in rheumatoid arthritis: systematic review and metaanalysis of efficacy and safety

Alonso-Ruiz, Alberto; Pijoan, Jose Ignacio; Ansuategui, Eukene; Urkaregi, Arantxa; Calabozo, Marcelo; Quintana, Antonio

doi:10.1186/1471-2474-9-52

Table 1 Summary of trials included in the metaanalysis

From: Tumor necrosis factor alpha drugs in rheumatoid arthritis: systematic review and metaanalysis of efficacy and safety

Trial (reference) Comparisons Jadad's scale (J)	Groups and N of patients		Mean age (years)	Mean disease duration (years)	N of swollen joints	N of tender joints	CRP (mg/dl)	HAQ	Mean N of previous DMARDs	Previous response to MTX
Lipsky et al. (19) Infliximab+MTX vs. MTX J [5]	3 mg/Kg 8 wk *	86	54	10	22	32	3.9	1.8	3.8	Insufficient
	3 mg/Kg 4 wk	86	52	9	21	31	3.5	1.7	2.6
	10 mg/Kg 8 wk	87	54	11	23	32	3.3	1.7	2.5
	10 mg/Kg 4 wk	81	52	12	24	34	4.2	1.7	2.5
	MTX	88	51	11	21	31	4.0	1.7	2.5
	total	428
St. Clair et al. (20) Infliximab+MTX vs. MTX J [3]	3 mg/Kg 8 wk *	373	51	0,8	21	32	2.9	1,5	71%	Not previously MTX
	6 mg/Kg 8 wk	378	50	0,9	22	33	3.0	1,5	68%
	MTX	298	50	0,9	22	34	2.6	1,5	65%
	total	1049							DMARDs naive
Quinn et al. (22) Infliximab+MTX vs. MTX J [3]	3 mg/Kg 8 wk *	10	51	0,6	NA	NA	4.7	1,3	Not previously DMARDs	Not previously MTX
	MTX	10	53	0,5			3.7	1.3
	total	20
Westhovens et al. (23) Infliximab+MTX vs. MTX J [4]	3 mg/Kg 8 wk *	360	53	7.8	15	22	1.6	1.5	NA	Insufficient
	10 mg/Kg 8 wk *	361	52	6.3	15	22	1.6	1.5
	MTX	363	52	8.4	15	22	1.2	1.5
	total	1084
Moreland et al. (24) Etanercept vs. placebo J [5]	25 mg twice weekly *	78		11	25	33	4.7	1.6	3.3	Insufficient
	10 mg twice weekly	76	53	13	25	34	5.3	1.7	3.4
	placebo	80	53	12	25	35	4.1	1.7	3.0
	total	234	51
Weinblatt et al. (25) Etanercept+MTX vs. MTX J [3]	25 mg twice weekly *	59		13	20	28	2.2	1.5	2.7	Insufficient
	MTX	30		13	17	28	2.6	1.5	2.8
	total	89	48
			53
Bathon et al. (26) Etanercept vs. MTX J [2]	25 mg twice weekly *	207	51	1	24	31	3.3	NA	0.5	Not previously MTX
	10 mg twice weekly	208	50	0.9	24	31	4.4		0.5
	MTX	217	49	1	24	30	3.7		0.6
	total	632
van der Heijde et al. (28) (TEMPO) Etanercept+MTX vs. MTX vs. Etanercept J [4]	25 mg twice weekly +MTX *	231		7	22	34	2.9	NA	2.3
	25 mg twice weekly *	223		6	23	35	2.2		2.3
	MTX	228	52	7	22	33	3.5		2.3
	total	682	53
			53
Weinblatt et al. (29) (ARMADA) Adalimumab+MT X vs. MTX J [3]	40 mg/2 wk *	67	57	12	17	28	2.1	1.5	2.9	Insufficient
	20 mg/2 wk	69	53	13	17	28	2.8	1.5	3.0
	80 mg/2 wk	73	55	12	17	30	2.8	1.5	3.1
	MTX	62	56	11	16	28	3.1	1.6	3.0
	total	271
van de Putte et al. (30) Adalimumab vs. Placebo J [5]	40 mg/2 wk *	113	52	10	20	33	5.2	1.8	3.8	Insufficient
	20 mg/2 wk	106	53	9	19	33	5.2	1.8	3.7
	20 mg/wk	112	54	11	19	35	4.7	1.8	3.6
	40 mg/wk	103	51	11	19	33	4.9	1.8	3.8
	Placebo	110	53	11	19	35	5.7	1.8	3.6
	total	544
Furst et al. (31) (STAR) Adalimumab+ DMARD vs. DMARD J [3]	40 mg/2 wk *	318		9	20	27	1.5	1.3	57–60%	Insufficient
	DMARD	318		11	21	27	1.5	1.4	2 or plus
	total	636	55
			55
Keystone et al. (32) Adalimumab+MT X vs. MTX J [3]	40 mg/2 wk *	207	56	11	19	27	1.8	1.4	2.4	Insufficient
	20 mg/wk	212	57	11	19	27	1.4	1.4	2.4
	MTX	200	56	10	19	28	1.8	1.4	2.4
	total	619
Breedveld et al. (33) (PREMIER) Adalimumab+MT X vs. MTX vs. Adalimumab J [4]	40 mg/2 wk + MTX *	268	52	0,7	21	31	NA	1.5	NA	Not previously MTX
	40 mg/2 wk	274	52	0,7	22	32		1.6
	MTX	257	52	0,8	22	32		1.5
	total	799

*groups receiving doses currently recommended
NA: not available
CRP: C-reactive protein
HAQ: health assessment questionnaire

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