PMID- 36792848
OWN - NLM
STAT- MEDLINE
DCOM- 20230524
LR  - 20230525
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Print)
IS  - 0770-3198 (Linking)
VI  - 42
IP  - 6
DP  - 2023 Jun
TI  - The efficacy and safety of olokizumab for rheumatoid arthritis: a systematic 
      review, pairwise, and network meta-analysis.
PG  - 1503-1520
LID - 10.1007/s10067-023-06519-6 [doi]
AB  - Olokizumab (OKZ) is a novel IL-6 inhibitor that directly targets IL-6 rather than 
      its receptor. We aim to evaluate the efficacy and safety of OKZ for patients with 
      rheumatoid arthritis (RA) and to investigate the optimal treatment regimen. A 
      systematic review, pairwise, and network meta-analysis synthesizing randomized 
      controlled trials (RCTs) from WOS, CENTRAL, SCOPUS, EMBASE, and PubMed until 
      August 31, 2022. We used the risk ratio (RR) and mean difference (MD) for 
      dichotomous and continuous outcomes, respectively, presented with the 
      corresponding 95% confidence interval (CI). We registered our protocol in 
      PROSPERO with ID: CRD42022358082. Five RCTs with 2277 patients were included. OKZ 
      significantly improved the American College of Rheumatology criteria (ACR) 20 
      (RR: 1.97 with 95% CI [1.49, 2.58], P = 0.00001), ACR50 (RR: 3.83 with 95% CI 
      [2.13, 6.87], P = 0.00001), ACR70 (RR: 3.83 with 95% CI [2.13, 6.87], 
      P = 0.00001), disease activity score 28 based on C-reactive protein (DAS28-CRP) 
      (RR: 3.91 with 95% CI [2.65, 5.79], P = 0.00001), clinical disease activity index 
      (CDAI) (RR: 2.80 with 95% CI [1.43, 5.48], P = 0.003), and health assessment 
      questionnaire disability index (HAQ-DI) (MD: - 0.28 with 95% CI [- 0.38, - 0.18], 
      P = 0.00001) after 12 weeks, compared to placebo. However, OKZ was also 
      associated with a higher incidence of any adverse events (AEs) (RR: 1.15 with 95% 
      CI [1.06, 1.25], P = 0.0005) and AEs leading to drug discontinuation (RR: 1.86 
      with 95% CI [1.05, 3.29], P = 0.03). OKZ is effective and with acceptable safety 
      profile when administrated with methotrexate in patients with RA not adequately 
      controlled by tumor necrosis factor inhibitors; however, more large-scale RCTs 
      are still required to investigate the optimal dosing, long-term effects, and 
      comparative efficacy versus established biological DMARDs. Key Points * OKZ is 
      effective especially with methotrexate in RA patients.
CI  - (c) 2023. The Author(s).
FAU - Abuelazm, Mohamed
AU  - Abuelazm M
AUID- ORCID: 0000-0002-2514-0689
AD  - Faculty of Medicine, Tanta University, Tanta, Egypt.
FAU - Ghanem, Ahmed
AU  - Ghanem A
AUID- ORCID: 0000-0002-1547-7886
AD  - Cardiology Department, The Lundquist Institute, Torrance, CA, USA.
FAU - Mahmoud, Abdelrahman
AU  - Mahmoud A
AUID- ORCID: 0000-0001-7514-1623
AD  - Faculty of Medicine, Minia University, Minia, Egypt.
FAU - Brakat, Aml M
AU  - Brakat AM
AUID- ORCID: 0000-0001-9786-2237
AD  - Faculty of Medicine, Zagazig University, Zagazig, Egypt.
FAU - Elzeftawy, Mohamad A
AU  - Elzeftawy MA
AUID- ORCID: 0000-0001-5619-9803
AD  - Faculty of Medicine, Tanta University, Tanta, Egypt.
FAU - Mamdouh Fayoud, Aya
AU  - Mamdouh Fayoud A
AUID- ORCID: 0000-0003-4139-8812
AD  - Faculty of Pharmacy, Kafr El-Shiekh University, Kafr El-Shiekh, Egypt.
FAU - Awad, Ahmed K
AU  - Awad AK
AUID- ORCID: 0000-0001-6647-1866
AD  - Faculty of Medicine, Ain-Shams University, Cairo, Egypt. ahmedkawad@gmail.com.
FAU - Abdelazeem, Basel
AU  - Abdelazeem B
AUID- ORCID: 0000-0002-2919-6196
AD  - Department of Internal Medicine, McLaren Health Care, Flint, MI, USA.
AD  - Department of Internal Medicine, Michigan State University, East Lansing, MI, 
      USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230216
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - PAI71R1D2W (olokizumab)
RN  - YL5FZ2Y5U1 (Methotrexate)
RN  - 0 (Antirheumatic Agents)
SB  - IM
MH  - Humans
MH  - Methotrexate/therapeutic use
MH  - Network Meta-Analysis
MH  - *Arthritis, Rheumatoid/drug therapy/chemically induced
MH  - *Antirheumatic Agents/adverse effects
MH  - Treatment Outcome
PMC - PMC10202974
OTO - NOTNLM
OT  - DMARDs
OT  - Meta-analysis
OT  - OKZ
OT  - Olokizumab
OT  - Rheumatoid arthritis
OT  - Systematic review
COIS- The authors declare no conflict of interest.
EDAT- 2023/02/16 06:00
MHDA- 2023/05/24 06:42
PMCR- 2023/02/16
CRDT- 2023/02/15 23:30
PHST- 2022/11/19 00:00 [received]
PHST- 2023/01/20 00:00 [accepted]
PHST- 2023/01/02 00:00 [revised]
PHST- 2023/05/24 06:42 [medline]
PHST- 2023/02/16 06:00 [pubmed]
PHST- 2023/02/15 23:30 [entrez]
PHST- 2023/02/16 00:00 [pmc-release]
AID - 10.1007/s10067-023-06519-6 [pii]
AID - 6519 [pii]
AID - 10.1007/s10067-023-06519-6 [doi]
PST - ppublish
SO  - Clin Rheumatol. 2023 Jun;42(6):1503-1520. doi: 10.1007/s10067-023-06519-6. Epub 
      2023 Feb 16.