PMID- 31165341
OWN - NLM
STAT- MEDLINE
DCOM- 20200501
LR  - 20200501
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 38
IP  - 10
DP  - 2019 Oct
TI  - Meta-analysis of IL-17 inhibitors in two populations of rheumatoid arthritis 
      patients: biologic-naive or tumor necrosis factor inhibitor inadequate 
      responders.
PG  - 2747-2756
LID - 10.1007/s10067-019-04608-z [doi]
AB  - OBJECTIVES: To evaluate the efficacy and safety of interleukin 17 (IL-17) 
      inhibitors in two rheumatoid arthritis (RA) populations: biologic-naive or tumor 
      necrosis factor inhibitor inadequate responders (TNF-IR). METHOD: A systematic 
      search was performed in major electronic databases to identify relevant 
      randomized controlled trials (RCTs) reporting the American College of 
      Rheumatology 20% (ACR20), ACR50, ACR70 responses and adverse events (AEs) of 
      IL-17 inhibitors versus placebo in patients with RA. We divided these patients 
      into two subgroups: biologic-naive or TNF-IR. The meta-analysis was performed 
      using Review Manager 5.3 software. Results were expressed as risk ratio (RR) with 
      pertinent 95% confidence interval (95% CI). RESULTS: Ten studies with a total of 
      2499 patients were included. For biologic-naive patients, ACR50 and ACR70 
      responses were significantly better with IL-17 inhibitors than placebo 
      (RR = 1.71, 95% CI 1.23-2.38, P = 0.001 and RR = 2.63, 95% CI 1.10-6.25, 
      P = 0.03, respectively), but ACR20 responses for IL-17 inhibitors were not 
      statistically superior to placebo (RR = 1.34, 95% CI 0.94-1.91, P = 0.11). For 
      TNF-IR, IL-17 inhibitors were effective in achieving ACR20 (RR = 1.67, 95% CI 
      1.40-2.00, P < 0.00001), ACR50 (RR = 1.94, 95% CI 1.43-2.63, P < 0.0001), and 
      ACR70 (RR = 2.11, 95% CI 1.26-3.55, P = 0.005) compared to placebo. In the safety 
      analysis, IL-17 inhibitors did not show increased risk of any AEs by comparing to 
      placebo in both biologic-naive patients and TNF-IR. CONCLUSION: IL-17 inhibitors 
      were effective in the treatment of RA without increased risk of AEs, whether for 
      biologic-naive patients or TNF-IR. Key Points * In this meta-analysis comparing 
      IL-17 inhibitors with placebo in 2499 rheumatoid arthritis patients, IL-17 
      inhibitors improved ACR50 and ACR70, but not ACR20, responses in biologic-naive 
      patients. * IL-17 inhibitors improved ACR20, ACR50, and ACR70 responses in tumor 
      necrosis factor inhibitor inadequate responders.
FAU - Wu, Dan
AU  - Wu D
AD  - Second Department of Rheumatology, Shengjing Hospital of China Medical 
      University, 39 Huaxiang Road, Tiexi District, Shenyang, 110072, Liaoning, China.
FAU - Hou, Si-Yuan
AU  - Hou SY
AD  - Intensive Care Unit, The People's Hospital of Liaoning Province, NO. 33 Wenyi 
      Road, Shenhe District, Shenyang, 110016, Liaoning, China.
FAU - Zhao, Shuai
AU  - Zhao S
AD  - Second Department of Rheumatology, Shengjing Hospital of China Medical 
      University, 39 Huaxiang Road, Tiexi District, Shenyang, 110072, Liaoning, China.
FAU - Hou, Lin-Xin
AU  - Hou LX
AD  - Second Department of Rheumatology, Shengjing Hospital of China Medical 
      University, 39 Huaxiang Road, Tiexi District, Shenyang, 110072, Liaoning, China.
FAU - Jiao, Ting
AU  - Jiao T
AD  - Second Department of Rheumatology, Shengjing Hospital of China Medical 
      University, 39 Huaxiang Road, Tiexi District, Shenyang, 110072, Liaoning, China.
FAU - Xu, Nan-Nan
AU  - Xu NN
AD  - Second Department of Rheumatology, Shengjing Hospital of China Medical 
      University, 39 Huaxiang Road, Tiexi District, Shenyang, 110072, Liaoning, China.
FAU - Zhang, Ning
AU  - Zhang N
AUID- ORCID: 0000-0002-3763-8361
AD  - Second Department of Rheumatology, Shengjing Hospital of China Medical 
      University, 39 Huaxiang Road, Tiexi District, Shenyang, 110072, Liaoning, China. 
      zhangn_sjhospital@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20190604
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Biological Products)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Interleukin-17)
RN  - 0 (Tumor Necrosis Factor Inhibitors)
RN  - 6ZA31Y954Z (brodalumab)
RN  - BTY153760O (ixekizumab)
RN  - DLG4EML025 (secukinumab)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Biological Products/*therapeutic use
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Interleukin-17/*antagonists & inhibitors
MH  - Randomized Controlled Trials as Topic
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor Inhibitors/*therapeutic use
OTO - NOTNLM
OT  - Biologic-naive
OT  - IL-17 inhibitors
OT  - Meta-analysis
OT  - Rheumatoid arthritis
OT  - TNF-IR
EDAT- 2019/06/06 06:00
MHDA- 2020/05/02 06:00
CRDT- 2019/06/06 06:00
PHST- 2019/01/01 00:00 [received]
PHST- 2019/05/15 00:00 [accepted]
PHST- 2019/04/26 00:00 [revised]
PHST- 2019/06/06 06:00 [pubmed]
PHST- 2020/05/02 06:00 [medline]
PHST- 2019/06/06 06:00 [entrez]
AID - 10.1007/s10067-019-04608-z [pii]
AID - 10.1007/s10067-019-04608-z [doi]
PST - ppublish
SO  - Clin Rheumatol. 2019 Oct;38(10):2747-2756. doi: 10.1007/s10067-019-04608-z. Epub 
      2019 Jun 4.