Compared efficacy of rituximab, abatacept, and tocilizumab in patients with rheumatoid arthritis refractory to methotrexate or TNF inhibitors agents: a systematic review and network meta-analysis

Table 1 Indirect comparisons among bDMARDs in active rheumatoid arthritis expressed in hazard ratios for achieving 70% of American College of Rheumatology response at six months with sensitive analyses

	ACR70 response rate, HR (95% CI), p value
	All trials	Excluding one trial from each class*
Abatacept versus Rituximab	1.017 (0.373, 2.845), p = 0.84	1.029 (0.324, 2.959), p = 0.88
Tocilizumab versus Rituximab	0.791 (0.254, 2.461), p = 0.32	0.811 (0.224, 2.618), p = 0.40
Tocilizumab versus Abatacept	0.806 (0.263, 2.505), p = 0.37	0.814 (0.237, 2.614), p = 0.43
Abatacept versus TNFi	1.043 (0.422, 2.242), p = 0.59	1.063 (0.402, 2.492), p = 0.56
Tocilizumab versus TNFi	0.839 (0.373, 3.804), p = 0.45	0.814 (0.331, 4.007), p = 0.41
Rituximab versus TNFi	1.059 (0.339, 2.581), p = 0.51	1.042 (0.305, 2.886), p = 0.67
Abatacept versus placebo	3.423 (1.422, 8.709), p < 0.001	3.438 (1.413, 8.762), p < 0.001
Tocilizumab versus placebo	2.765 (1.240, 6.692), p = 0.009	2.525 (1.096, 6.921), p = 0.015
Rituximab versus placebo	3.494 (1.530, 8.658), p < 0.001	3.509 (1.522, 8.676), p < 0.001

Random effects standard deviation for all trials 0.854 (0.537, 1.408), Inconsistency factor (distance between direct and indirect effects) are 0.021 (− 2.661, 2.607, p = 0.988), 0.032 (− 2.592, 2.557, p = 0.934), 0.038 (− 2.711, 2.557, p = 0.984), − 1.247 (− 3.628, 1.148 p = 0.271), − 1.028 (− 3.924, 1.018 p = 0.176), 0.150 (− 1.764, 2.109, p = 0.879), 0.714 (− 1.353, 2.751, p = 0.468), − 1.278 (− 3.576, 1.094, p = 0.248), 0.666 (− 1.304, 2.635, p = 0.476), respectively for the node-split comparisons Abatacept versus Rituximab, Tocilizumab versus Rituximab, Tocilizumab versus Abatacept, Abatacept versus TNFi, Tocilizumab versus TNFi, Rituximab versus TNFi, Abatacept versus placebo, Tocilizumab versus placebo, Rituximab vs placebo. For ACR70 network meta-analysis model fit statistics posterior mean of the residual deviance (D_res = 40.1), and deviance information criterion (DIC) = 77.1
TNFi tumor necrosis factor inhibitors; HR hazard ratio; ACR70 70% of American College of Rheumatology
^*Sensitivity analysis: excluding trials with largest exposure (in patient-years) from each class

ISSN: 2523-3106