Biological disease-modifying antirheumatic drugs found to be effective in a systematic review

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Biological disease-modifying antirheumatic drugs found to be effective in a systematic review

According to a systematic review by Nam JL et al., which is recently published in Annals of Rheumatic Diseases, disease-modifying anti-rheumatic drugs (DMARDs) are found to be an effective approach in the management of rheumatoid arthritis.

Disease-modifying anti-rheumatic drugs refer to the category of unrelated drugs used to slow down the progression of rheumatoid arthritis (RA). This term is used in contrast to the non-steroidal anti-inflammatory drug (NSAIDs) and steroids.

The present study aims to notify the authentications that support the effectiveness of biological DMARDs in treating RA and to inform European League Against Rheumatism (EULAR) Task Force the recommendations for treatment. The method was based on searching the prior literature for phase III or IV (or phase II, if these studies were lacking) randomized controlled trials (RCTs) published between January 2013 and February 2016 by using databases like MEDLINE, EMBASE, and Cochrane. Abstracts from the American College of Rheumatology and EULAR conferences were also obtained in this method of investigation.

Results indicated that greater efficacy of biological DMRD (bDMARD) + conventional synthetic DMARD (csDMARD) versus a csDMARDs alone (level 1A evidence) used in the RCTs. There was an effective approach that used a treat-to-target strategy approach that commences and escalates csDMARD therapy and adds bDMARD in cases of non-response. If a bDMARD had failed, improvements in clinical response were seen on switching to another bDMARD (1A), but there was no clear advantage of switching to an agent with a different mode of action. For maintaining clinical response in patients in remission or low disease activity, it is best to continue rather than stopping a bDMARD, but bDMARD dose can be reduced, or ‘spacing' was possible, with a substantial proportion of patients achieving bDMARD-free remission (2B). RCTs have also defined the efficacy of several new bDMARDs and biosimilar DMARDs (1B).

Overall, it was validated by this review that bDMARD are efficient in treating RA. Additional information regarding bDMARD switching and dose reduction was also concluded in the review.


Annals of Rheumatic Diseases

Link to the source:

The original title of the article:

Efficacy of biological disease-modifying anti-rheumatic drugs: a systematic literature review informing the 2016 update of the EULAR recommendations for the management of rheumatoid arthritis


Jackie L Nam et al

Biological disease-modifying antirheumatic drugs, DMARDs
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