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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 human leucocyte antigen B27 (HLAB27) as predictor of response in ankylosing spondylitis (AS). (A) Meta-analysis of HLAB27 and ASAS20 in AS. (B) Meta-analysis of HLAB27 and ASAS40 in AS. (C) Meta-analysis of HLAB27 and BASDAI50 in AS.
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RMDOPEN2014000017F4: Meta-analysis of human leucocyte antigen B27 (HLAB27) as predictor of response in ankylosing spondylitis (AS). (A) Meta-analysis of HLAB27 and ASAS20 in AS. (B) Meta-analysis of HLAB27 and ASAS40 in AS. (C) Meta-analysis of HLAB27 and BASDAI50 in AS.

Mentions: Twelve articles analysed genetic factors as predictors of response to TNF antagonists in AS.125263235434650–525457 Human leucocyte antigen B27 (HLA-B27) was investigated in nine articles with contradictory results.1252632354650–52 Meta-analysis of HLA-B27 and ASAS20 in three studies showed an OR of 2.81 (0.95 to 7.16) with an I2 of 81.5% (figure 4A), and no risk of publication bias (p=0.075).12526 No factor was identified as a source of heterogeneity. Meta-analysis of HLA-B27 and ASAS40 in three studies showed an OR of 1.83 (1.39 to 2.42) with an I2 of 0.0% (figure 1B), and no risk of publication bias (p=0.628).253550 Meta-analysis of HLA-B27 and BASDAI50 in three studies,354651 and subgroups of other study,52 showed an OR of 1.81 (1.35 to 2.42) with an I2 of 0.0% (figure 1C), and no risk of publication bias (p=0.074). No association was shown between −308 TNF gene polymorphism and BASDAI response.5457 Association was reported of the rs396991 Fc γ-receptor (FCGR) 3A polymorphism with BASDAI50 response.43


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 human leucocyte antigen B27 (HLAB27) as predictor of response in ankylosing spondylitis (AS). (A) Meta-analysis of HLAB27 and ASAS20 in AS. (B) Meta-analysis of HLAB27 and ASAS40 in AS. (C) Meta-analysis of HLAB27 and BASDAI50 in AS.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

RMDOPEN2014000017F4: Meta-analysis of human leucocyte antigen B27 (HLAB27) as predictor of response in ankylosing spondylitis (AS). (A) Meta-analysis of HLAB27 and ASAS20 in AS. (B) Meta-analysis of HLAB27 and ASAS40 in AS. (C) Meta-analysis of HLAB27 and BASDAI50 in AS.
Mentions: Twelve articles analysed genetic factors as predictors of response to TNF antagonists in AS.125263235434650–525457 Human leucocyte antigen B27 (HLA-B27) was investigated in nine articles with contradictory results.1252632354650–52 Meta-analysis of HLA-B27 and ASAS20 in three studies showed an OR of 2.81 (0.95 to 7.16) with an I2 of 81.5% (figure 4A), and no risk of publication bias (p=0.075).12526 No factor was identified as a source of heterogeneity. Meta-analysis of HLA-B27 and ASAS40 in three studies showed an OR of 1.83 (1.39 to 2.42) with an I2 of 0.0% (figure 1B), and no risk of publication bias (p=0.628).253550 Meta-analysis of HLA-B27 and BASDAI50 in three studies,354651 and subgroups of other study,52 showed an OR of 1.81 (1.35 to 2.42) with an I2 of 0.0% (figure 1C), and no risk of publication bias (p=0.074). No association was shown between −308 TNF gene polymorphism and BASDAI response.5457 Association was reported of the rs396991 Fc γ-receptor (FCGR) 3A polymorphism with BASDAI50 response.43

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