Indirect Treatment Comparison in Meta-Analysis Using Three Methods for Rheumatoid Arthritis

Abstract

Background: The data were extracted from the comparative effectiveness review (CER) on pharmacological treatments for rheumatoid arthritis (RA) developed by the International University of North Carolina Evidence Based Practice Center (UNC EPC). The included studies enrolled patients with active RA despite oral disease-modifying antirheumatic drugs (DMARD) therapy. The outcome measures of choice were American College of Rheumatology (ACR) 20/50/70 response rates.

Objective: To compare and find the best treatment for RA among Adalimumab (Drug A), Infliximab (Drug B) and Certolizumab (Drug C) by using three different methods of indirect treatment comparison (ITC) in meta-analysis.

Methods: Three different methods of ITC were used. They were—Bucher, a simplest method which compares two treatments through a single common comparator; Lumley, the network comparison which compares two treatments through more than one common comparator or linking treatment; and the Confidence Profile method which compares two treatments through many comparators by using Bayesian technique.

Results: The Odds ratio obtained from Bucher ITC was =0.417 (CI: 0.282 to 0.610) and =0.334 (CI: 0.226 to 0.495); Lumley’s OR was =0.327 (CI: 0.0041, 26) and =0.342 (CI: 0.0043, 27.15). By using Confidence Profile method, =0.369 (CI: 0.204, 0.76) and =0.305 (CI: 0.164, 0.636). The Odds ratio obtained from all the three methods was similar, concluding that Certolizumab is better as compared to Adalimumab and Infliximab.

Conclusion: Certolizumab is the best treatment for RA among various treatments.

Keywords: rheumatoid arthritis (RA), meta-analysis, indirect treatment comparison, Bayesian method, odds ratio

Cite this Article

Iswarya M. Indirect Treatment Comparison in Meta-Analysis Using Three Methods for Rheumatoid Arthritis. Research & Reviews: Journal of Computational Biology. 2018; 7(1): 22–27p.