IF 3.8 3区 医学 Q1 RHEUMATOLOGY
Sélina Hanna, Tiphaine Dujardin, Philippe Gaudin, Athan Baillet, Xavier Romand
{"title":"bDMARD Drug Survival In Combination Therapy With Methotrexate In Psoriatic Arthritis: a Systematic Literature Review And Meta-analysis.","authors":"Sélina Hanna, Tiphaine Dujardin, Philippe Gaudin, Athan Baillet, Xavier Romand","doi":"10.1016/j.jbspin.2025.105854","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/purpose: </strong>Combination therapy with methotrexate (MTX) has shown to improve biologic Disease Modifying Rheumatic Drugs (bDMARD) survival in rheumatoid arthritis, but interest in MTX combination therapy in Psoriatic Arthritis (PsA) remains controversial. We conducted a systematic literature review and meta-analysis to study whether a combination therapy bDMARD and MTX improves bDMARD drug survival in PsA.</p><p><strong>Methods: </strong>We performed a systematic literature review to identify all pertinent articles studying ts/bDMARDs drugs survival (TNF inhibitors (TNFi), IL-17, IL-23, IL-12/23 and JAK inhibitors) and MTX in PsA up until December 2023. Hazard ratio's (HR) were extracted. A random-effect model and inverse-variance method were used. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity and to confirm the robustness of the results.</p><p><strong>Results: </strong>2,299 records were identified, and twenty studies were included, with a total of 30,634 patients with PsA. All studies were observational. Two studies involved bDMARDs other than TNFi. Combination therapy with MTX was found to be associated with a superior bDMARDs drug survival (HR = 0.82 [CI95%, 0.75, 0.89], p-value < 0.001, I<sup>2</sup>=45%) and TNFi drug survival (HR=0.79 [CI95%, 0.73, 0.86], p-value < 0.001, I<sup>2</sup>=27%). A meta-analysis for non-TNFi was not possible due to the limited number of publications.</p><p><strong>Conclusion: </strong>This meta-analysis shows the positive association between combination therapy bDMARD with MTX and a better bDMARDs drug survival, especially with TNFi. Further studies are needed to confirm this hypothesis with robust evidence such as randomised controlled trials.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105854"},"PeriodicalIF":3.8000,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint Bone Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jbspin.2025.105854","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景/目的:与甲氨蝶呤(MTX)的联合疗法已被证明可改善类风湿性关节炎中生物改变病情药物(bDMARD)的存活率,但对银屑病关节炎(PsA)中MTX联合疗法的兴趣仍存在争议。我们进行了一项系统性文献综述和荟萃分析,研究 bDMARD 和 MTX 联合疗法是否能提高 bDMARD 药物在 PsA 中的存活率:我们进行了系统性文献综述,以确定截至2023年12月所有研究ts/bDMARDs药物(TNF抑制剂(TNFi)、IL-17、IL-23、IL-12/23和JAK抑制剂)和MTX在PsA中存活率的相关文章。提取了危险比(HR)。采用随机效应模型和逆方差法。进行了敏感性分析和亚组分析,以确定异质性的来源,并确认结果的稳健性。结果:共发现 2,299 条记录,纳入了 20 项研究,共计 30,634 名 PsA 患者。所有研究均为观察性研究。两项研究涉及 TNFi 之外的 bDMARDs。研究发现,与MTX联合治疗可提高bDMARDs药物的生存率(HR=0.82 [CI95%,0.75,0.89],P值<0.001,I2=45%)和TNFi药物的生存率(HR=0.79 [CI95%,0.73,0.86],P值<0.001,I2=27%)。由于论文数量有限,无法对非TNFi进行荟萃分析:这项荟萃分析表明,bDMARD与MTX联合治疗与bDMARDs药物生存率之间存在正相关,尤其是TNFi。还需要进一步研究,通过随机对照试验等有力证据来证实这一假设。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
bDMARD Drug Survival In Combination Therapy With Methotrexate In Psoriatic Arthritis: a Systematic Literature Review And Meta-analysis.

Background/purpose: Combination therapy with methotrexate (MTX) has shown to improve biologic Disease Modifying Rheumatic Drugs (bDMARD) survival in rheumatoid arthritis, but interest in MTX combination therapy in Psoriatic Arthritis (PsA) remains controversial. We conducted a systematic literature review and meta-analysis to study whether a combination therapy bDMARD and MTX improves bDMARD drug survival in PsA.

Methods: We performed a systematic literature review to identify all pertinent articles studying ts/bDMARDs drugs survival (TNF inhibitors (TNFi), IL-17, IL-23, IL-12/23 and JAK inhibitors) and MTX in PsA up until December 2023. Hazard ratio's (HR) were extracted. A random-effect model and inverse-variance method were used. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity and to confirm the robustness of the results.

Results: 2,299 records were identified, and twenty studies were included, with a total of 30,634 patients with PsA. All studies were observational. Two studies involved bDMARDs other than TNFi. Combination therapy with MTX was found to be associated with a superior bDMARDs drug survival (HR = 0.82 [CI95%, 0.75, 0.89], p-value < 0.001, I2=45%) and TNFi drug survival (HR=0.79 [CI95%, 0.73, 0.86], p-value < 0.001, I2=27%). A meta-analysis for non-TNFi was not possible due to the limited number of publications.

Conclusion: This meta-analysis shows the positive association between combination therapy bDMARD with MTX and a better bDMARDs drug survival, especially with TNFi. Further studies are needed to confirm this hypothesis with robust evidence such as randomised controlled trials.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Joint Bone Spine
Joint Bone Spine 医学-风湿病学
CiteScore
4.50
自引率
11.90%
发文量
184
审稿时长
25 days
期刊介绍: Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信