A Network Meta-Analysis Comparing Efficacy and Safety of Tofacitinib and Baricitinib
Bae SC and Lee YH. - Z Rheumatol. 2018 Sep 6. DOI 10.1007/s00393-018-0531-5
Tofacitinib (TOF) 10mg and baricitinib (BARI) 4mg, in combination with methotrexate (MTX), were the most efficacious treatments in RA patients with an inadequate response to DMARDs or biologics. Both combination treatments presented acceptable safety profiles and were not associated with a significant risk of serious adverse events.
This study employed a Bayesian approach to Meta-Analysis; combining the available evidence across a network of Randomised Controlled trials (RCTs).
Twelve RCTs containing 5883 patients were included in the analysis. The study evaluated the number of patients who achieved an ACR20 responses as the efficacy outcome and the number of patients who experienced serious adverse events (SAEs) as the safety outcome.
TOF 10 mg + MTX and BARI 4 mg + MTX were the most effective treatments for active RA with an inadequate DMARD or biologic response, followed by BARI 2 mg + MTX and TOFA 5 mg + MTX. Ranking analysis showed TOF 10mg + MTX to have the highest probability of achieving ACR20, followed by BARI 4 mg + MTX, BARI 2 mg + MTX and TOF 5 mg + MTX. No significant differences were observed in the incidence of SAEs after treatment with TOF + MTX or BARI + MTX.
Overall, the data indicate that TOF 10mg + MTX and BARI 4mg + MTX were the most efficacious intervention and were not associated with a significant risk of SAEs, in patients with RA and inadequate responses to DMARDs or biologics.