Relative Efficacy and Safety of Anti-Inflammatory Biologic Agents for Osteoarthritis: A Conventional and Network Meta-Analysis

Overview

Journal J Clin Med

Specialty General Medicine

Date 2022 Jul 27

PMID 35887724

Authors

Yang Li

Yiying Mai

Peihua Cao

Xin Wen

Tianxiang Fan

Xiaoshuai Wang

Guangfeng Ruan

Suan Tang

Changhai Ding

Zhaohua Zhu

Affiliations

Soon will be listed here.

Abstract

Methods: Five databases were searched for randomized controlled trials (RCTs) comparing biologics with placebo or each other in OA patients. Data of pain, physical function, stiffness, and adverse events (AEs) were extracted for a conventional and a Bayesian network meta-analysis.

Results: 15 studies with data for 1566 patients were analyzed. In the conventional meta-analysis, etanercept (SMD -0.47; 95% CI -0.89, -0.05) and infliximab (SMD -2.04; CI -2.56, -1.52) were superior to placebo for knee pain. In the network meta-analysis, infliximab was superior to all the other biologic agents in improving pain (vs. hyaluronic acid (SMD -22.95; CI -34.21, -10.43), vs. adalimumab (SMD -21.71; CI -32.65, -11.00), vs. anakinra (SMD -24.63; CI -38.79, -10.05), vs. canakinumab (SMD -32.83; CI -44.45, -20.68), vs. etanercept (SMD -18.40; CI -29.93, -5.73), vs. lutikizumab (SMD -25.11; CI -36.47, -14.78), vs. naproxen (SMD -30.16; CI -41.78, -17.38), vs. tocilizumab (SMD -24.02; CI -35.63, -11.86) and vs. placebo (SMD -25.88; CI -34.87, -16.60)). No significant differences were observed between biologics and placebo regarding physical function, stiffness, and risk of AEs.

Conclusions: The findings suggest that infliximab may relieve pain more than other biological agents in OA patients. No significant differences were observed between biologics and placebo regarding physical function, stiffness, and risk of AEs. The results must be interpreted cautiously; therefore, further randomized controlled trials are warranted.

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References

Wojtyniak J, Britz H, Selzer D, Schwab M, Lehr T . Data Digitizing: Accurate and Precise Data Extraction for Quantitative Systems Pharmacology and Physiologically-Based Pharmacokinetic Modeling. CPT Pharmacometrics Syst Pharmacol. 2020; 9(6):322-331. PMC: 7306621. DOI: 10.1002/psp4.12511. View

Wang J . Efficacy and safety of adalimumab by intra-articular injection for moderate to severe knee osteoarthritis: An open-label randomized controlled trial. J Int Med Res. 2017; 46(1):326-334. PMC: 6011328. DOI: 10.1177/0300060517723182. View

Brown T, Laurent U, Fraser J . Turnover of hyaluronan in synovial joints: elimination of labelled hyaluronan from the knee joint of the rabbit. Exp Physiol. 1991; 76(1):125-34. DOI: 10.1113/expphysiol.1991.sp003474. View

Jethwa H, Abraham S . Biologic agents in inflammatory arthritis. Br J Gen Pract. 2018; 68(669):204-205. PMC: 5863676. DOI: 10.3399/bjgp18X695705. View

van der Heijde D, Dijkmans B, Geusens P, Sieper J, DeWoody K, Williamson P . Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT). Arthritis Rheum. 2005; 52(2):582-91. DOI: 10.1002/art.20852. View

Verbruggen G, Wittoek R, Vander Cruyssen B, Elewaut D . Tumour necrosis factor blockade for the treatment of erosive osteoarthritis of the interphalangeal finger joints: a double blind, randomised trial on structure modification. Ann Rheum Dis. 2011; 71(6):891-8. PMC: 3371224. DOI: 10.1136/ard.2011.149849. View

Higgins J, Altman D, Gotzsche P, Juni P, Moher D, Oxman A . The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011; 343:d5928. PMC: 3196245. DOI: 10.1136/bmj.d5928. View

van Schouwenburg P, Rispens T, Wolbink G . Immunogenicity of anti-TNF biologic therapies for rheumatoid arthritis. Nat Rev Rheumatol. 2013; 9(3):164-72. DOI: 10.1038/nrrheum.2013.4. View

Garces S, Demengeot J, Benito-Garcia E . The immunogenicity of anti-TNF therapy in immune-mediated inflammatory diseases: a systematic review of the literature with a meta-analysis. Ann Rheum Dis. 2012; 72(12):1947-55. DOI: 10.1136/annrheumdis-2012-202220. View

10.

Fleischmann R, Bliddal H, Blanco F, Schnitzer T, Peterfy C, Chen S . A Phase II Trial of Lutikizumab, an Anti-Interleukin-1α/β Dual Variable Domain Immunoglobulin, in Knee Osteoarthritis Patients With Synovitis. Arthritis Rheumatol. 2019; 71(7):1056-1069. DOI: 10.1002/art.40840. View

11.

Richette P, Latourte A, Sellam J, Wendling D, Piperno M, Goupille P . Efficacy of tocilizumab in patients with hand osteoarthritis: double blind, randomised, placebo-controlled, multicentre trial. Ann Rheum Dis. 2020; 80(3):349-355. DOI: 10.1136/annrheumdis-2020-218547. View

12.

Bannuru R, Osani M, Vaysbrot E, Arden N, Bennell K, Bierma-Zeinstra S . OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019; 27(11):1578-1589. DOI: 10.1016/j.joca.2019.06.011. View

13.

Tschon M, Contartese D, Pagani S, Borsari V, Fini M . Gender and Sex Are Key Determinants in Osteoarthritis Not Only Confounding Variables. A Systematic Review of Clinical Data. J Clin Med. 2021; 10(14). PMC: 8303951. DOI: 10.3390/jcm10143178. View

14.

Kloppenburg M, Peterfy C, Haugen I, Kroon F, Chen S, Wang L . Phase IIa, placebo-controlled, randomised study of lutikizumab, an anti-interleukin-1α and anti-interleukin-1β dual variable domain immunoglobulin, in patients with erosive hand osteoarthritis. Ann Rheum Dis. 2018; 78(3):413-420. PMC: 6390132. DOI: 10.1136/annrheumdis-2018-213336. View

15.

Trivedi S, Fang W, Ayyalasomayajula I, Vangsness C . Pharmacotherapeutic considerations and options for the management of osteoarthritis in women. Expert Opin Pharmacother. 2020; 21(5):557-566. DOI: 10.1080/14656566.2020.1718649. View

16.

Hawker G . Osteoarthritis is a serious disease. Clin Exp Rheumatol. 2019; 37 Suppl 120(5):3-6. View

17.

Persson M, Sarmanova A, Doherty M, Zhang W . Conventional and biologic disease-modifying anti-rheumatic drugs for osteoarthritis: a meta-analysis of randomized controlled trials. Rheumatology (Oxford). 2018; 57(10):1830-1837. PMC: 6199417. DOI: 10.1093/rheumatology/key131. View

18.

Wang S, Abramson S, Attur M, Karsdal M, Preston R, Lozada C . Safety, tolerability, and pharmacodynamics of an anti-interleukin-1α/β dual variable domain immunoglobulin in patients with osteoarthritis of the knee: a randomized phase 1 study. Osteoarthritis Cartilage. 2017; 25(12):1952-1961. DOI: 10.1016/j.joca.2017.09.007. View

19.

Shen J, Abu-Amer Y, OKeefe R, McAlinden A . Inflammation and epigenetic regulation in osteoarthritis. Connect Tissue Res. 2016; 58(1):49-63. PMC: 5266560. DOI: 10.1080/03008207.2016.1208655. View

20.

Juni P, Reichenbach S, Dieppe P . Osteoarthritis: rational approach to treating the individual. Best Pract Res Clin Rheumatol. 2006; 20(4):721-40. DOI: 10.1016/j.berh.2006.05.002. View