Comparison of the efficacy and safety indicators of DMARDs for rheumatoid arthritis: A network meta-analysis

Wang, Zunlian; Huang, Min; Yu, Bin; Huang, Yilan; Zheng, Silin; Yang, Xuping; Ning, Hong

OBJECTIVE: To compare efficacy and safety indicators of disease-modifying antirheumatic drugs, Sarilumab, Sirukumab, Baricitinib, Tocilizumab and Adalimumab in rheumatoid arthritis treatment by a network meta-analysis. METHODS: Medline, Embase, Web of Science, The Food and Drug Administration web site, and Cochrane library were searched from build to June 1, 2020. Clinical randomized controlled trails of these 5 drugs for rheumatoid arthritis were collected for network meta-analysis. RESULTS: A total of 4 randomized controlled trails with 2070 patients were obtained. The results of the network meta-analysis showed that: (1).. There was no significant difference between the 4 drugs (Sarilumab, Sirukumab, Adalimumab, and Tocilizumab) (P > .05) in terms of American College of Rheumatology 20. (2).. There was no significant difference between the 5 drugs in the aspect of the America College of Rheumatology 50% and 70% (American College of Rheumatology 50, American College of Rheumatology 70) (P > .05). (3).. There was no significant difference between the 3 drugs (Sarilumab, Sirukumab, Adalimumab) in terms of reducing disease activity score 28-erythrocyte sedimentation rate in patients (P > .05). (4).. No significant difference was observed among the 5 drugs in terms of incidence of adverse reactions, serious adverse reactions and withdrawal adverse reactions (P > .05). The results of the ranked probability plot indicated that Tocilizumab and Sarilumab outperform other drugs in terms of efficacy and safety. CONCLUSION: The results of the ranking of the 5 drugs showed that Tocilizumab and Sarilumab had the best efficacy and safety.