List of publications, posters and presentations

Spurden D, Orme ME, Mitchell S, Bird A. Systematic Review and Network Meta-analysis of Biological Therapy for the Management of Active Psoriatic Arthritis (SAT0298)


Background: Psoriatic arthritis (PsA) is a chronic systemic inflammatory disease with articular and dermatological manifestations. PsA varies in severity and type of tissue involvement and may significantly impact patients’ function and quality of life. Objectives: To determine the relative effectiveness of UK licensed biological disease-modifying anti-rheumatic drugs (bDMARDs) for the treatment of active, progressive PsA in patients with inadequate response to previous DMARDs. Methods: A systematic review was conducted to identify relevant randomised controlled trials (RCTs) of bDMARDS. The main outcomes of interest included number of patients meeting Psoriatic Arthritis Response Criteria (PsARC) at follow-up and change in Health Assessment Questionnaire (HAQ) score from baseline conditional on PsARC response. Literature searches were conducted in relevant electronic databases and the grey literature. Data were extracted by two independent reviewers. A Bayesian network meta-analysis (NMA) was conducted in WinBUGs using a fixed and random-effects logit model fitted to the binomial data and an identity model for the continuous data. Results: 2,099 citations were identified and on reviewing full-text papers, 30 publications of 12 studies met the criteria for inclusion in the review. On review of the dataset, seven placebo-controlled studies of licensed bDMARDs were included in the NMA: two studies of adalimumab (ADA) 40 mg every other week (n=204) vs PLA (n=211); two studies of etanercept (ETN) 25 mg twice weekly (n=131) vs placebo (PLA) (n=134); one study of golimumab (GOL) 50 mg every 4 weeks (n=146) vs PLA (n=113) (plus unlicensed arm: not shown); and two studies of infliximab (IFX) 5 mg/kg (n=152) vs PLA (n=152). The table summarises the fixed-effect NMA results for PsARC, and change in HAQ (for all patients and conditional on PsARC response) based on 12 to 16 week follow-up data. Similar results were obtained with random-effects NMA and results were subject to a sensitivity analysis

Presented at the Annual European Congress of Rheumatology EULAR 2012, June 6-9, Berlin, Germany.

Citation: EULAR 2012