PMID- 27889300
OWN - NLM
STAT- MEDLINE
DCOM- 20171025
LR  - 20220321
IS  - 1879-114X (Electronic)
IS  - 0149-2918 (Linking)
VI  - 38
IP  - 12
DP  - 2016 Dec
TI  - Tofacitinib Versus Biologic Treatments in Patients With Active Rheumatoid 
      Arthritis Who Have Had an Inadequate Response to Tumor Necrosis Factor 
      Inhibitors: Results From a Network Meta-analysis.
PG  - 2628-2641.e5
LID - S0149-2918(16)30837-2 [pii]
LID - 10.1016/j.clinthera.2016.11.004 [doi]
AB  - PURPOSE: Tofacitinib is an oral Janus kinase inhibitor for the treatment of 
      rheumatoid arthritis (RA). This analysis compared the efficacy and safety of 
      tofacitinib with biologic disease-modifying antirheumatic drugs in patients with 
      RA and a prior inadequate response (IR) to tumor necrosis factor inhibitors 
      (TNFi). METHODS: A systematic literature review identified 5 randomized 
      placebo-controlled trials that evaluated tofacitinib or biologic 
      disease-modifying antirheumatic drugs (bDMARDs) against placebo in patient 
      populations with RA with a prior IR to TNFi. The definition of TNFi-IR varied 
      across studies, and included patients with an IR or who had failed treatment with 
      TNFi for any reason. A network meta-analysis was conducted comparing study data 
      with regard to American College of Rheumatology response rates and Health 
      Assessment Questionnaire-Disability Index improvement at weeks 12 and 24, rates 
      of treatment withdrawal due to all causes; adverse events (AEs) and lack of 
      efficacy; and rates of AEs, serious AEs, and serious infections. FINDINGS: The 5 
      trials included a total of 2136 patients. Tofacitinib 5 mg twice daily combined 
      with methotrexate was found to have relative risk estimates of American College 
      of Rheumatology responses and change from baseline in Health Assessment 
      Questionnaire-Disability Index score comparable with abatacept, golimumab, 
      rituximab, and tocilizumab combined with conventional synthetic disease-modifying 
      antirheumatic drugs. Withdrawal rates from trials due to all causes and AEs were 
      comparable between treatments, and tofacitinib had a lower rate of withdrawals 
      due to lack of efficacy. Rates of AEs and HAQ-DI were comparable between 
      tofacitinib, other active treatments, and placebo. No serious infections were 
      reported with tofacitinib during the placebo-controlled period (up to week 12) in 
      this study population; rates of serious infection with other active treatments 
      were generally low and similar to placebo. IMPLICATIONS: During a 24-week period, 
      tofacitinib had efficacy and rates of AEs comparable with currently available 
      bDMARDs in the treatment of patients with RA who had a prior IR to TNFi. 
      ClinicalTrials.gov identifiers: ORAL Step, NCT00960440; ATTAIN, NCT00124982; 
      GO-AFTER, NCT00299546; RADIATE, NCT00106522; REFLEX, NCT00462345.
CI  - Copyright (c) 2016 Elsevier HS Journals, Inc. All rights reserved.
FAU - Vieira, Maria-Cecilia
AU  - Vieira MC
AD  - Mapi, Boston, Massachusetts.
FAU - Zwillich, Samuel H
AU  - Zwillich SH
AD  - Pfizer Inc, Groton, Connecticut.
FAU - Jansen, Jeroen P
AU  - Jansen JP
AD  - Tufts University School of Medicine, Boston, Massachusetts.
FAU - Smiechowski, Brielan
AU  - Smiechowski B
AD  - Mapi, Boston, Massachusetts.
FAU - Spurden, Dean
AU  - Spurden D
AD  - Pfizer Inc, Tadworth, Surrey, UK.
FAU - Wallenstein, Gene V
AU  - Wallenstein GV
AD  - Pfizer Inc, Groton, Connecticut. Electronic address: gene.wallenstein@pfizer.com.
LA  - eng
SI  - ClinicalTrials.gov/NCT00960440
SI  - ClinicalTrials.gov/NCT00462345
SI  - ClinicalTrials.gov/NCT00124982
SI  - ClinicalTrials.gov/NCT00106522
SI  - ClinicalTrials.gov/NCT00299546
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20161124
PL  - United States
TA  - Clin Ther
JT  - Clinical therapeutics
JID - 7706726
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Biological Products)
RN  - 0 (Piperidines)
RN  - 0 (Pyrimidines)
RN  - 0 (Pyrroles)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 7D0YB67S97 (Abatacept)
RN  - 87LA6FU830 (tofacitinib)
RN  - 91X1KLU43E (golimumab)
RN  - I031V2H011 (tocilizumab)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Abatacept/therapeutic use
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antibodies, Monoclonal, Humanized/therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Biological Products/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Male
MH  - Methotrexate/therapeutic use
MH  - Network Meta-Analysis
MH  - Piperidines/*therapeutic use
MH  - Pyrimidines/*therapeutic use
MH  - Pyrroles/*therapeutic use
MH  - Rituximab/therapeutic use
MH  - Treatment Failure
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
OTO - NOTNLM
OT  - *disease-modifying antirheumatic drugs
OT  - *rheumatoid arthritis
OT  - *tofacitinib
OT  - *tumor necrosis factor inhibitors
EDAT- 2016/11/28 06:00
MHDA- 2017/10/27 06:00
CRDT- 2016/11/28 06:00
PHST- 2016/01/27 00:00 [received]
PHST- 2016/10/31 00:00 [revised]
PHST- 2016/11/01 00:00 [accepted]
PHST- 2016/11/28 06:00 [pubmed]
PHST- 2017/10/27 06:00 [medline]
PHST- 2016/11/28 06:00 [entrez]
AID - S0149-2918(16)30837-2 [pii]
AID - 10.1016/j.clinthera.2016.11.004 [doi]
PST - ppublish
SO  - Clin Ther. 2016 Dec;38(12):2628-2641.e5. doi: 10.1016/j.clinthera.2016.11.004. 
      Epub 2016 Nov 24.