Cochrane · systematic review · CD004525
Etanercept for the treatment of rheumatoid arthritis
Lethaby, A, Lopez‐Olivo, MA, Maxwell, LJ, et al. · Cochrane Database of Systematic Reviews · 2013 · Cochrane Library
MusculoskeletalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
25
current version
GRADE rated
20
No studies
2
Included studies
NR
No studies 2 · 8%Ungraded 3 · 12%Very low 0 · 0%Low 0 · 0%Moderate 9 · 36%High 11 · 44%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Inadequate responders to traditional disease‐modifying anti‐rheumatic drugs (DMARDs)
Population: participants with rheumatoid arthritis and with a partial response to DMARDs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
ACR50 American College of Rheumatology 50% improvement criteria | RR 1.96 [1.33, 2.89] | 4 studies · 1198 participants | Moderate Downgraded: inconsistency |
Remission Achievement of disease activity score < 2.6 | RR 1.92 [1.6, 2.31] | 2 studies · 987 participants | High |
Reduction in disability score Health Assessment Questionnaire. Scale from: 0 to 3 | no estimate extracted | 4 studies · 1227 participants | High |
Radiographic progression Total Sharp Score Scale from: 0 to 448 | no estimate extracted | 2 studies · 903 participants | Moderate Downgraded: inconsistency |
Withdrawals due to adverse events | RR 0.75 [0.57, 1] | 4 studies · 1241 participants | Moderate Downgraded: inconsistency |
Serious adverse events | RR 1.25 [0.74, 2.11] | 4 studies · 1241 participants | Moderate Downgraded: inconsistency |
Serious infections | RR 0.91 [0.54, 1.55] | 3 studies · 1152 participants | High |
Inadequate responders to methotrexate (MTX)
Population: participants with rheumatoid arthritis and with partial response to MTX
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
ACR50 American College of Rheumatology improvement criteria | RR 11.69 [1.66, 82.47] | 1 study · 89 participants | Moderate Downgraded: imprecision |
Remission Disease activity score < 2.6 | no estimate extracted | 0 studies · 0 participants | Ungraded |
Reduction in disability score Health Assessment Questionnaire (mean improvement from baseline). Scale from: 0 to 3 | no estimate extracted | 1 study · 89 participants | Moderate Downgraded: imprecision |
Radiographic progression Total Sharp Score | no estimate extracted | 0 studies · 0 participants | Ungraded |
Withdrawals due to adverse events | RR 1.02 [0.1, 10.77] | 1 study · 89 participants | Moderate Downgraded: imprecision |
Serious adverse events | RR 0.25 [0.05, 1.31] | 1 study · 89 participants | Moderate Downgraded: imprecision |
Serious infections | no estimate extracted | 0 studies · 0 participants | Ungraded |
ACR50, radiographic progression and serious infections
Population: participants with rheumatoid arthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Etanercept (25 mg) + DMARD | RR 1.52 [1.36, 1.7] | 2 studies · 958 participants | High |
Etanercept (10 mg) | RR 0.76 [0.58, 0.99] | 1 study · 423 participants | High |
Etanercept (25 mg) | RR 7.95 [2.94, 21.47] | 1 study · 158 participants | High |
Serious infections | no estimate extracted | NR | No studies |
Subgroup analyses: ACR50
Population: participants with rheumatoid arthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome: ACR50 ‐ American College of Rheumatology Improvement Criteria | no estimate extracted | NR | No studies |
Etanercept + DMARD vs. DMARD | RR 2.82 [1.71, 4.68] | 5 studies · 1118 participants | High |
Etanercept vs. DMARD | RR 1.17 [1.02, 1.35] | 3 studies · 1112 participants | High |
Etanercept + DMARD vs. Etanercept | RR 1.44 [1.16, 1.79] | 3 studies · 805 participants | Moderate |
Radiographic outcomes
Population: participants with rheumatoid arthritis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Etanercept (25 mg) + DMARD | no estimate extracted | 2 studies · 894 participants | High |
Etanercept (10 mg) | no estimate extracted | 1 study · 425 participants | High |
Etanercept (25 mg) | no estimate extracted | 1 study · 424 participants | High |