A systematic review of the effectiveness of adalimumab

50
Effectiveness
Review: Etanercept for rheumatoid arthritis 2006
Comparison: 01 Etanercept s.c. licensed dose only (25 mg twice weekly or 50 mg once weekly) vs placebo, end of trial
Outcome: 03 ACR70 responder
Study
or subcategory
Etanercept
n/N
Control
n/N
01 With (+) or without (–) concurrent, ongoing conventional DMARDs
Wadjula, 2000126 [12 weeks] (–)
Moreland, 1999122 [26 weeks] (–)
Keystone, 2004129 [8 weeks] (±)
Lan, 2004130 [12 weeks] (+)
Weinblatt, 1999125 [24 weeks] (+)
Codreanu, 2003103 [24 weeks] (+)
Subtotal (95% CI)
Total events: 79 (etanercept), 4 (control)
Test for heterogeneity: 2 = 3.05, df = 5 (p = 0.69), I2 14/109
31/78
12/367
7/29
9/59
25/100
1/100
1/80
1/53
0/29
0/30
1/50
742 342
= 0%
Test for overall effect: z = 5.10 (p < 0.00001)
02 With concurrent, newly initiated MTX (etanercept + MTX)
TEMPO 110 [100 weeks] (+)
Subtotal (95% CI)
Total events: 95 (etanercept), 37 (control)
Test for heterogeneity: NA
Test for overall effect: z = 5.48 (p < 0.00001)
95/231 37/228
231 228
Total (95% CI)
Total events: 174 (etanercept), 41 (control)
Test for heterogeneity: 2 = 10.45, df = 6 (p = 0.11), I2 973 570
= 42.6%
Test for overall effect: z = 7.83 (p < 0.00001)
RR (fixed)
95% CI
0.01 0.1 1 10 100
Favours control Favours etanercept
Weight
%
2.40
2.27
4.02
1.15
1.52
3.06
14.41
85.59
85.99
100.00
FIGURE 28 ACR70 RR: etanercept licensed dose versus placebo (including etanercept plus MTX versus MTX)
Review: Etanercept for rheumatoid arthritis 2006
Comparison: 01 Etanercept s.c. licensed dose only (25 mg twice weekly or 50 mg once weekly) vs placebo, end of trial
Outcome: 03 ACR70 responder
Study
or subcategory
Etanercept
n/N
Control
n/N
01 With (+) or without (–) concurrent, ongoing conventional DMARDs
Wadjula, 2000126 [12 weeks] (–)
Moreland, 1999122 [26 weeks] (–)
Keystone, 2004129 [8 weeks] (±)
Lan, 2004130 [12 weeks] (+)
Weinblatt, 1999125 [24 weeks] (+)
Codreanu, 2003103 [24 weeks] (+)
Subtotal (95% CI)
Total events: 79 (etanercept), 4 (control)
Test for heterogeneity: 2 = 37.33, df = 5 (p < 0.00001), I2 14/109
31/78
12/367
7/29
9/59
25/100
1/100
1/80
1/53
0/29
0/30
1/50
742 342
= 86.6%
Test for overall effect: z = 7.67 (p < 0.00001)
02 With concurrent, newly initiated MTX (etanercept + MTX)
TEMPO 110 [100 weeks] (+)
Subtotal (95% CI)
Total events: 95 (etanercept), 37 (control)
Test for heterogeneity: NA
Test for overall effect: z = 6.14 (p < 0.00001)
95/231 37/228
231 228
Total (95% CI)
Total events: 174 (etanercept), 41 (control)
Test for heterogeneity: 2 = 66.57, df = 6 (p < 0.00001), I2 973 570
= 91.0%
Test for overall effect: z = 9.51 (p < 0.00001)
RD (fixed)
95% CI
–1 –0.5 0 0.5 1
Favours control Favours etanercept
Weight
%
16.28
12.33
14.45
4.53
6.21
10.40
64.19
35.81
35.81
100.00
FIGURE 29 ACR70 RD: etanercept licensed dose versus placebo (including etanercept plus MTX versus MTX)
RR (fixed)
95% CI
12.84 (1.72 to 95.9)
12.31 (1.64 to 92.41)
1.73 (0.23 to 13.06)
15.00 (0.90 to 251.06)
9.82 (0.59 to 163.15)
12.50 (1.74 to 89.61)
9.44 (3.98 to 22.38)
2.53 (1.82 to 3.54)
2.53 (1.82 to 3.54)
RD (fixed)
95% CI
0.12 (0.05, 0.18)
0.14 (0.06, 0.23)
0.01 (–0.03 to 0.05)
0.24 (0.08 to 0.40)
0.15 (0.05 to 0.26)
0.23 (0.14 to 0.32)
0.13 (0.10 to 0.16)
0.25 (0.17 to 0.33)
0.25 (0.17 to 0.33)