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Predictors of response to TNF antagonists in patients with ankylosing spondylitis and psoriatic arthritis: systematic review and meta-analysis.

Maneiro JR, Souto A, Salgado E, Mera A, Gomez-Reino JJ - RMD Open (2015)

Bottom Line: Similar results were found for ASAS criteria response.No predictors of response were identified in PsA.Young age, male sex, high baseline BASDAI, low baseline BASFI, high baseline CRP and HLA-B27 predict better response to TNF antagonists in AS but not in PsA.

View Article: PubMed Central - PubMed

Affiliation: Rheumatology Unit , Complejo Hospitalario Universitario de Santiago de Compostela , Santiago , Spain.

ABSTRACT

Objective: To identify predictors of response to tumor necrosis factor (TNF) antagonists in ankylosing spondylitis (AS) and psoriatic arthritis (PsA).

Methods: Systematic review and meta-analysis of clinical trials and observational studies based on a systematic search. Meta-analyses of similar observations were performed using random effects computing summary OR. Heterogeneity was tested using I(2), and risks of bias using funnel plots and the Egger test. Meta-regression was used to explore causes of heterogeneity.

Results: The electronic search captured 1340 references and 217 abstracts. 17 additional articles were identified after searching by hand. A total of 59 articles meet the purpose of the study and were reviewed. 37 articles (33 studies) included 6736 patients with AS and 23 articles (22 studies) included 4034 patients with PsA. 1 article included data on AS and PsA. Age (OR (95% CI) 0.91 (0.84 to 0.99), I(2)=84.1%), gender (1.57 (1.10 to 2.25), I(2)=0.0%), baseline BASDAI (1.31 (1.09 to 1.57), I(2)=0.0%), baseline BASFI (0.86 (0.79 to 0.93), I(2)=24.9%), baseline dichotomous C reactive protein (CRP) (2.14 (1.71 to 2.68), I(2)=22.3%) and human leucocyte antigen B27 (HLA-B27) (1.81 (1.35 to 2.42), I(2)=0.0%) predict BASDAI50 response in AS. No factor was identified as a source of heterogeneity. Only meta-analysis of baseline BASFI showed risk of publication bias (Egger test, p=0.004). Similar results were found for ASAS criteria response. No predictors of response were identified in PsA.

Conclusions: Young age, male sex, high baseline BASDAI, low baseline BASFI, high baseline CRP and HLA-B27 predict better response to TNF antagonists in AS but not in PsA.

No MeSH data available.


Related in: MedlinePlus

Meta-analysis of BASDAI baseline and BASFI baseline as predictors of response in ankylosing spondylitis (AS). (A) Meta-analysis of BASDAI baseline and BASDAI50 in AS. (B) Meta-analysis of BASFI baseline and BASDAI50 in AS.
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RMDOPEN2014000017F2: Meta-analysis of BASDAI baseline and BASFI baseline as predictors of response in ankylosing spondylitis (AS). (A) Meta-analysis of BASDAI baseline and BASDAI50 in AS. (B) Meta-analysis of BASFI baseline and BASDAI50 in AS.

Mentions: Twenty-one articles included data about clinical factors as predictors of response in AS.252629303234353940–42444648–535556 Five studies included data on BASDAI baseline.2640525556 Individual results showed that higher baseline BASDAI predicts better BASDAI504052 and ASDAS,55 but not ASAS20 response.56 Meta-analysis of baseline BASDAI and BASDAI50 in one study40 and subgroups of another study52 showed an OR of 1.31 (1.09 to 1.57) with I2 of 0.0%, and no risk of publication bias (p=0.673) (figure 2A). Eight studies analysed baseline BASFI.2630344051525556 Individual results showed that higher baseline BASFI predicts poor BASDAI50 response,34405152 but not ASAS20 response.263056 A meta-analysis including four studies showed an OR of 0.86 (0.79 to 0.93) with I2 of 24.9% (figure 2B) and risk of publication bias (p=0.004).34405152


Predictors of response to TNF antagonists in patients with ankylosing spondylitis and psoriatic arthritis: systematic review and meta-analysis.

Maneiro JR, Souto A, Salgado E, Mera A, Gomez-Reino JJ - RMD Open (2015)

Meta-analysis of BASDAI baseline and BASFI baseline as predictors of response in ankylosing spondylitis (AS). (A) Meta-analysis of BASDAI baseline and BASDAI50 in AS. (B) Meta-analysis of BASFI baseline and BASDAI50 in AS.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612701&req=5

RMDOPEN2014000017F2: Meta-analysis of BASDAI baseline and BASFI baseline as predictors of response in ankylosing spondylitis (AS). (A) Meta-analysis of BASDAI baseline and BASDAI50 in AS. (B) Meta-analysis of BASFI baseline and BASDAI50 in AS.
Mentions: Twenty-one articles included data about clinical factors as predictors of response in AS.252629303234353940–42444648–535556 Five studies included data on BASDAI baseline.2640525556 Individual results showed that higher baseline BASDAI predicts better BASDAI504052 and ASDAS,55 but not ASAS20 response.56 Meta-analysis of baseline BASDAI and BASDAI50 in one study40 and subgroups of another study52 showed an OR of 1.31 (1.09 to 1.57) with I2 of 0.0%, and no risk of publication bias (p=0.673) (figure 2A). Eight studies analysed baseline BASFI.2630344051525556 Individual results showed that higher baseline BASFI predicts poor BASDAI50 response,34405152 but not ASAS20 response.263056 A meta-analysis including four studies showed an OR of 0.86 (0.79 to 0.93) with I2 of 24.9% (figure 2B) and risk of publication bias (p=0.004).34405152

Bottom Line: Similar results were found for ASAS criteria response.No predictors of response were identified in PsA.Young age, male sex, high baseline BASDAI, low baseline BASFI, high baseline CRP and HLA-B27 predict better response to TNF antagonists in AS but not in PsA.

View Article: PubMed Central - PubMed

Affiliation: Rheumatology Unit , Complejo Hospitalario Universitario de Santiago de Compostela , Santiago , Spain.

ABSTRACT

Objective: To identify predictors of response to tumor necrosis factor (TNF) antagonists in ankylosing spondylitis (AS) and psoriatic arthritis (PsA).

Methods: Systematic review and meta-analysis of clinical trials and observational studies based on a systematic search. Meta-analyses of similar observations were performed using random effects computing summary OR. Heterogeneity was tested using I(2), and risks of bias using funnel plots and the Egger test. Meta-regression was used to explore causes of heterogeneity.

Results: The electronic search captured 1340 references and 217 abstracts. 17 additional articles were identified after searching by hand. A total of 59 articles meet the purpose of the study and were reviewed. 37 articles (33 studies) included 6736 patients with AS and 23 articles (22 studies) included 4034 patients with PsA. 1 article included data on AS and PsA. Age (OR (95% CI) 0.91 (0.84 to 0.99), I(2)=84.1%), gender (1.57 (1.10 to 2.25), I(2)=0.0%), baseline BASDAI (1.31 (1.09 to 1.57), I(2)=0.0%), baseline BASFI (0.86 (0.79 to 0.93), I(2)=24.9%), baseline dichotomous C reactive protein (CRP) (2.14 (1.71 to 2.68), I(2)=22.3%) and human leucocyte antigen B27 (HLA-B27) (1.81 (1.35 to 2.42), I(2)=0.0%) predict BASDAI50 response in AS. No factor was identified as a source of heterogeneity. Only meta-analysis of baseline BASFI showed risk of publication bias (Egger test, p=0.004). Similar results were found for ASAS criteria response. No predictors of response were identified in PsA.

Conclusions: Young age, male sex, high baseline BASDAI, low baseline BASFI, high baseline CRP and HLA-B27 predict better response to TNF antagonists in AS but not in PsA.

No MeSH data available.


Related in: MedlinePlus