Thursday, 20 Feb 2020

You are here

Is There a Standout When Comparing Novel Therapies?

Randomized clinical trials are needed to show efficacy and safety, and are needed to back up the claims and indications for a particular drug. The issue of treatment choice has become challenging, especially when choosing to start or augment therapy. Do I aim for monotherapy or continue to advocate for combination therapy to achieve superior outcomes?  This systematic analysis identified 28 RCTs evaluating abatacept, anakinra, adalimumab, certolizumab, etanercept, golimumab, infliximab, tocilizumab, or tofacitinib. Using indirect comparisons of ACR 20/50/70 data, nearly all of these novel therapies had similar effects, especially if used in combination with methotrexate, in incomplete DMARD responders.  However, when when used as monotherapy, greater responses were seen with tocilizumab, compared with tofacitinib or TNF inhibitors. Responses to tocilizumab monotherapy was similar to tocilizumab plus MTX. Its unclear from the available data if tofacitinib monotherapy is equivalent to tofacitinib plus MTX.

The author has received research/grant financial support on this subject
The author has received compensation as an advisor or consultant on this subject

Add new comment

More Like This

Tofacitinib Effective in Refractory Still's Disease

Fourteen cases reported from mainland China suggest that tofacitinib (TOFA) may be effective in patients with refractory adult-onset Still’s disease (AOSD), further adding to a growing list of potential use of JAK inhibition in managing inflammatory, and now autoinflammatory, disease.

QD Clinic - Hepatitis B and Biologics

QD Clinic - Lessons from the clinic Active HBV infection (HGsAg+) on anti-viral therapy but needs a biologic - what should you use?

Biosimilars for Rheum Disease: Failure to Launch

The availability of biologic biosimilars has thus far had negligible impact on prescribing practices in the United States, in stark contrast to what has been observed in some European countries, researchers reported.

Best of 2019 - Is Methotrexate Necessary with Tofacitinib?

Rheumatoid arthritis patients taking tofacitinib (Xeljanz) plus methotrexate who achieved low disease activity (LDA) may be able to withdraw from the latter agent without significant worsening of disease activity, a researcher reported at EULAR 2019 in Madrid.

Best of 2019 - Ups and Downs with Abatacept

Two recent studies have examined the effect of starting abatacept upon the risk of serious hospitalized infections or cancer, showing divergent results from claims data analyses.