Next Article in Journal
A Molecular Dynamics Study of Vasoactive Intestinal Peptide Receptor 1 and the Basis of Its Therapeutic Antagonism
Next Article in Special Issue
Mechanism of Action of the Tumor Vessel Targeting Agent NGR-hTNF: Role of Both NGR Peptide and hTNF in Cell Binding and Signaling
Previous Article in Journal
Inhibition of Mitochondrial Complex I Impairs Release of α-Galactosidase by Jurkat Cells
Open AccessReview

Different Original and Biosimilar TNF Inhibitors Similarly Reduce Joint Destruction in Rheumatoid Arthritis—A Network Meta-Analysis of 36 Randomized Controlled Trials

1
The Lupus and Vasculitis Clinic VRR 4242, Copenhagen University Hospital, Blegdamsvej 9, DK 2100 Copenhagen, Denmark
2
Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Munkesøvej 18, 4000 Roskilde, Denmark
3
NNF Center for Protein Research, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
4
Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK 8200 Aarhus, Denmark
5
Deparment of Population Health Science, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Rd, Bristol BS8 2PS, UK
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(18), 4350; https://doi.org/10.3390/ijms20184350
Received: 9 July 2019 / Revised: 24 August 2019 / Accepted: 29 August 2019 / Published: 5 September 2019
(This article belongs to the Special Issue Tumor Necrosis Factor (TNF) II)
The effect of five approved tumour necrosis factor inhibitors (TNFi: infliximab, etanercept, adalimumab, certolizumab, and golimumab) on joint destruction in rheumatoid arthritis (RA) have been compared versus methotrexate (MTX) in randomized controlled trials (RCTs) but have not been compared directly to each other or to an otherwise untreated placebo control. The present analysis compares effects of standard doses, high doses, and low doses of TNFis on radiographic joint destruction in RA and relate these effects to MTX and placebo by means of a Bayesian network meta-analysis. We identified 31 RCTs of the effect of TNFis on joint destruction and 5 RCTs with controls, which indirectly could link otherwise untreated placebo controls to the TNFi treatments in the network. The previously untested comparison with placebo was performed to estimate not only the effect relative to another drug, but also the absolute attainable effect. Compared to placebo there was a highly significant inhibitory effect on joint destruction of infliximab, etanercept, adalimumab, certolizumab, and golimumab, which was about 0.9% per year as monotherapy and about 1.2% per year when combined with MTX. Although significantly better than MTX and placebo, golimumab seemed inferior to the remaining TNFis. There was no difference between original reference drugs (Remicade, Enbrel) and the almost identical copy drugs (biosimilars). View Full-Text
Keywords: rheumatoid arthritis; tumor necrosis factor (TNF) inhibitors; joint destruction; randomized controlled trial; network meta-analysis rheumatoid arthritis; tumor necrosis factor (TNF) inhibitors; joint destruction; randomized controlled trial; network meta-analysis
Show Figures

Figure 1

MDPI and ACS Style

Graudal, N.; Kaas-Hansen, B.S.; Guski, L.; Hubeck-Graudal, T.; Welton, N.J.; Jürgens, G. Different Original and Biosimilar TNF Inhibitors Similarly Reduce Joint Destruction in Rheumatoid Arthritis—A Network Meta-Analysis of 36 Randomized Controlled Trials. Int. J. Mol. Sci. 2019, 20, 4350.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop