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Productos biológicos o tofacitinib para pacientes con artritis tratados sin éxito con productos biológicos: una revisión sistemática y un metanálisis en red

Appendices

Appendix 1. Standard, approved doses of biologics or tofacitinib for the treatment of RA

Drug

Standard approved US dose

Abatacept

IV: (10mg/kg every 4 weeks): every 4 weeks intravenously at 500 mg dose in patients < 60 kg, 750 mg in patients 60‐100 kg and 1000 mg in patients > 100 kg, after the initial dosing regimen of baseline, 2 and 4‐week infusions;

SQ: After a single intravenous infusion as a loading dose (as per body weight categories above), 125 mg administered by a subcutaneous injection should be given within a day, followed by 125 mg subcutaneously once a week.

Adalimumab

40 mg subcutaneous every 2 weeks

Anakinra

100 mg subcutaneous every day

Certolizumab

400 mg (given as two subcutaneous injections of 200 mg) initially and at Weeks 2 and 4, followed by 200 mg every other week. For maintenance dosing, CIMZIA 400 mg every 4 weeks can be considered.

Etanercept

25 mg subcutaneous twice weekly

Golimumab

SQ: 50 mg subcutaneous every 4 weeks

IV: 2 mg/kg given as an intravenous infusion at weeks 0 and 4, then every 8 weeks

Infliximab

SQ: 3 mg/kg intravenous every 8 weeks after initial dosing at 0, 2 and 6 weeks

Tocilizumab

IV: 4 mg/kg every 4 weeks followed by an increase to 8 mg/kg based on clinical response

SQ: 162 mg administered subcutaneously every other week, followed by an increase to every week based on clinical response for patients < 100 kg and 162 mg administered subcutaneously every week for patients >= 100 kg body weight.

Rituximab

IV: two 1000 mg IV doses 2 weeks apart

Tofacitinib

5 mg twice daily

Abbreviations:

IV: intravenous
SQ: subcutaneous

Appendix 2. List of ongoing clinical trials in the WHO trials register and Clinicaltrials.gov

NCT Number

Title

ACTRN12605000784617

A phase IIIb multi‐center, randomized, double‐blind study to evaluate remission and joint damage progression in methotrexate naive early erosive RA subjects treated with abatacept plus methotrexate compared with methotrexate

ACTRN12605000785606

A phase II study of abatacept versus placebo to assess the prevention of rheumatoid arthritis (RA) in adult patients with undifferentiated arthritis who are at high risk for the development of RA

ACTRN12606000248561

A phase 1 randomised double blind, placebo‐controlled, single dose, dose escalation study of kb002, a chimeric monoclonal antibody which binds to granulocyte macrophage‐colony stimulating factor (gm‐csf), in patients with rheumatoid arthritis

ACTRN12608000397314

Multi‐national open‐label study to evaluate the safety, tolerability and efficacy of tocilizumab versus tocilizumab plus non‐biologic disease modifying antirheumatic drugs in patients with active rheumatoid arthritis

ACTRN12609000747224

Extension phase of the multi‐national open‐label study to evaluate the safety, tolerability and efficacy of tocilizumab in patients with active rheumatoid arthritis on background non‐biologic disease‐modifying anti‐rheumatic drugs (DMARDs) who have an inadequate response to current non‐biologic DMARD and/or anti tumor necrosis factor (anti‐TNF) therapy

ACTRN12610000284066

A longitudinal study of patients with rheumatoid arthritis starting biological therapy; assessment of joint inflammation by use of ultrasonography

ACTRN12611000972921

The hunter Humira and endothelial function in early rheumatoid arthritis trial

ACTRN12611001202954

A comparison of arthroscopic synovial biopsy based targeted biologic therapy versus conventional therapy in rheumatoid arthritis (RA)

ACTRN12614000903684

A randomized, single‐blind, single‐dose, 3‐arm, parallel group study to determine the pharmacokinetic similarity of abp 710 and infliximab (Remicade 'registered trademark') in healthy adult subjects

ACTRN12615000557538

Hunter heart‐RA‐2 (HHRA‐2) study: a randomised controlled trial evaluating the effects of Humira upon cardiovascular risk as measured by endothelial function in patients with rheumatoid arthritis who test positive for anti‐CCP antibodies as well as those who test negative for anti‐CCP antibodies

ChiCTR‐CCC‐10001054

Circulating dickkopf‐1 (DKK‐1) is correlated with bone erosion and inflammation in rheumatoid arthritis

ChiCTR‐IIR‐16008693

Pharmacokinetics, safety and tolerability study of single dose of abatacept 125mg administered subcutaneously

ChiCTR‐INR‐16009546

The efficacy and safety of low dose il‐2 combined il‐6 antagonist therapy in Chinese over‐treated patients with rheumatoid arthritis

ChiCTR‐TRC‐09000383

Efficacy and safety of recombinant human il‐1 receptor antagonist in Chinese patients with rheumatoid arthritis: a double‐blind, randomized, placebo‐controlled trial

ChiCTR‐TRC‐10001060

Efficacy and safety of infliximab in Chinese patients with rheumatoid arthritis: a double‐blind, randomized, placebo‐controlled trial

CTRI/2008/091/000295

A clinical trial to study the safety and effectiveness of a monoclonal antibody in combination with methotrexate in patients with active rheumatoid arthritis

CTRI/2012/05/002660

A clinical study to demonstrate safety and efficacy data to support the development of R‐TPR‐015 (1422015) in patients with active rheumatoid arthritis on stable dose of methotrexate.

CTRI/2013/05/003678

“A randomized controlled study to evaluate pharmacokinetic, pharmacodynamic (efficacy) and safety of rituximab (Zydus) and rituximab (Roche) in patients with rheumatoid arthritis

CTRI/2013/09/003963

Study to compare the safety and efficacy of etanercept of Intas biopharmaceuticals ltd against Enbrel® in patients with active rheumatoid arthritis

CTRI/2013/10/004040

A study to evaluate efficacy, tolerability and safety of adalimumab (Zydus) and adalimumab (Reference) in patients with rheumatoid arthritis

CTRI/2014/04/004571

A clinical trial to study the effects of two drugs, R‐TPR‐021 / Humira® in patients with active rheumatoid arthritis on a stable dose of methotrexate

CTRI/2014/07/004742

Phase III clinical trial comparing efficacy and safety of BCD‐020 (CJSC BIOCAD, Russia) and Mabthera® (f. Hoffmann‐la Roche ltd., Switzerland) in patients with rheumatoid arthritis.

CTRI/2014/09/004954

A clinical trial to study the effects of three anti‐cd20 monoclonal antibodies in patients with moderate to severe active, seropositive rheumatoid arthritis with an inadequate response to methotrexate based therapy.

CTRI/2015/01/005398

A study to determine pharmacodynamics (effect of drug in the body) and to compare pharmacokinetics (how drug behaves in the body), Safety and tolerability of single dose of Lupin’s Rituximab with Roche’s Rituximab following I.V. infusion in Patients with Rheumatoid Arthritis

CTRI/2016/02/006625

A clinical trial to evaluate efficacy and safety of BMO‐2 and adalimumab in patient with active rheumatoid arthritis

CTRI/2016/04/006884

A clinical study to evaluate the efficacy, safety, immunogenicity, and pharmacokinetics of subcutaneous injection of adalimumab (test product, Hetero) and reference medicinal product (reference product, Abbvie) concomitantly administered with methotrexate in patients with rheumatoid arthritis

CTRI/2016/05/006899

A study to compare the biosimilar of Etanercept (coded as YLB113) made by YLBiologics with Enbrel (originator’s Etanercept) in patients suffering from rheumatoid arthritis with respect to its efficacy, safety and antibody formation.

CTRI/2016/07/007097

Multi‐centre, randomized, double‐blind, two‐arm, parallel group, comparative clinical study to evaluate pharmacokinetic, efficacy and safety of etanercept in patients with active rheumatoid arthritis

DRKS00011083

Clinical study of an anthroposophic treatment strategy for early rheumatoid arthritis, compared to conventional long‐term therapy

EUCTR2004‐000563‐96‐HU

A 24‐month, randomized, double‐blind, two period study to evaluate the efficacy and safety of the combination of etanercept and methotrexate and methotrexate alone in subjects with active early rheumatoid arthritis: combination of methotrexate and etanercept

EUCTR2004‐000922‐59‐SE

A phase III, multi‐center, randomized, double‐blind, placebo‐controlled comparative study of abatacept or infliximab in combination with methotrexate in controlling disease activity in subjects with rheumatoid arthritis having an inadequate clinical response to methotrexate.

EUCTR2004‐002620‐18‐DE

A multi‐national randomized, double‐blind, exploratory study of abatacept versus placebo in preventing the development of rheumatoid arthritis in adult subjects with undifferentiated inflammatory arthritis at high risk for the development of rheumatoid arthritis

EUCTR2004‐002993‐49‐HU

A phase III multicentre, double blind, placebo‐controlled, parallel group 52‐week study to assess the efficacy and safety of 2 dose regimens of lyophilised cdp870 given subcutaneously as additional medication to methotrexate in the treatment of signs and symptoms and preventing structural damage in patients with active rheumatoid arthritis who have an incomplete response to methotrexate.

EUCTR2004‐003295‐10‐GB

A multicenter, randomized, double‐blind, placebo‐controlled trial of golimumab, a fully human anti‐TNFalfa monoclonal antibody, administered subcutaneously, in methotrexate‐naïve subjects with active rheumatoid arthritis ‐ na

EUCTR2004‐003296‐36‐DE

A multicenter, randomized, double‐blind, placebo‐controlled trial of golimumab, a fully human anti‐TNFalfa monoclonal antibody, administered subcutaneously, in subjects with active rheumatoid arthritis despite methotrexate therapy ‐ na

EUCTR2004‐003299‐12‐FI

A multicenter, randomized, double‐blind, placebo‐controlled trial of golimumab, a fully human anti‐TNFalfa monoclonal antibody, administered subcutaneously, in subjects with active ankylosing spondylitis ‐ na

EUCTR2004‐003733‐14‐FI

A study investigating whether tocilizumab (study drug) prevents joint damage, and how safe it is, in patients with moderate to severe rheumatoid arthritis randomly divided to groups receiving treatment with tocilizumab and methotrexate or methotrexate and placebo.

EUCTR2004‐003741‐40‐AT

A randomized, double‐blind, parallel group study of the safety and reduction of signs and symptoms during treatment with mra versus placebo, in combination with methotrexate, in patients with moderate to severe active rheumatoid arthritis.

EUCTR2004‐003771‐37‐HU

A double‐blind, randomized, placebo controlled, dose escalation, multi‐center phase I/II trial of humax‐cd20, a fully human monoclonal anti‐cd20 antibody, in patients with active rheumatoid arthritis who have previously failed one or more disease modifying anti‐rheumatic drugs. ‐ humax‐cd20 in active rheumatoid arthritis, phase I/II

EUCTR2004‐005210‐37‐DE

A randomized, double‐blind, placebo‐controlled, parallel group study of the safety and reduction of signs and symptoms during treatment with MRA versus placebo, in combination with traditional DMARD therapy in patients with moderate to severe active rheumatoid arthritis and an inadequate response to current DMARD therapy.

EUCTR2005‐000492‐18‐IT

Insulin resistance and endothelial dysfunction TNF‐alpha dependent in patients with rheumatoid arthritis or metabolic syndrome

EUCTR2005‐000674‐43‐GB

An open label study of the effect of treatment with rituximab on resistant rheumatoid arthritis: clinical, radiological, synovial and immunological outcomes ‐ rituximab in rheumatoid arthritis

EUCTR2005‐000784‐26‐GB

A phase IIIb multi‐center, randomized, double‐blind study to evaluate remission and joint damage progression in methotrexate naive early erosive RA subjects treated with abatacept plus methotrexate compared with methotrexate revised protocol 04

EUCTR2005‐000884‐25‐DE

A randomized, double‐blind, placebo‐controlled, parallel group study of the safety and reduction of signs and symptoms during treatment with MRA versus placebo, in combination with methotrexate in patients with moderate to severe active rheumatoid arthritis and an inadequate response to previous anti‐TNF therapy.

EUCTR2005‐001138‐33‐LT

A randomized, double‐blind, double‐dummy, parallel group study of the safety and efficacy of mra monotherapy, versus methotrexate (MTX) monotherapy, in patients with active rheumatoid arthritis.

EUCTR2005‐001549‐41‐HU

A randomised, double‐blind study comparing the safety and efficacy of etanercept with sulphasalazine in subjects with ankylosing spondylitis ‐ ASCEND

EUCTR2005‐001633‐14‐DK

Randomised, multi‐center, open‐label, parallel‐group study comparing adalimumab (Humira?) 40 mg s.c. Eow versus infliximab (Remicade®) 3 mg/kg i.v. Every 6. Week in RA patients with unsustainable clinical response to infliximab 3 mg/kg every 8. Week ‐ The SWITCH Study

EUCTR2005‐001742‐16‐GB

A multicenter, randomized, double‐blind, placebo‐controlled trial of golimumab, a fully human anti‐TNFalfa monoclonal antibody, administered subcutaneously in subjects with active rheumatoid arthritis and previously treated with biologic anti‐TNFalfa agent(s) ‐ go‐after

EUCTR2005‐001889‐13‐SE

Randomised controlled trial evaluating strategies to optimize disease activity control in RA patients treated with infliximab in clinical practice. ‐ RE3

EUCTR2005‐002326‐63‐LT

A phase III multi–center, double–blind, placebo–controlled, parallel group 24–week study to assess the efficacy and safety of two dose regimens of liquid certolizumab pegol as additional medication to methotrexate

EUCTR2005‐002392‐32‐IE

A randomised, placebo controlled, double‐blind, parallel group, international study to evaluate the safety and efficacy of rituximab (Mabthera/Rituxan) in combination with methotrexate, compared to methotrexate monotherapy, in patients with active rheumatoid arthritis.

EUCTR2005‐002395‐15‐FI

A randomized, phase 3, controlled, double‐blind, parallel‐group, multicenter study to evaluate the safety and efficacy of rituximab in combination with methotrexate (MTX) compared to MTX alone, in methotrexate‐naïve patients with active rheumatoid arthritis.

EUCTR2005‐002396‐33‐ES

A randomised, double‐blind, international study to evaluate the efficacy and safety of various re‐treatment regimens of rituximab in combination with methotrexate in RA patients with an inadequate response to methotrexate.

EUCTR2005‐002423‐13‐DE

Long‐term extension study of safety during treatment with tocilizumab (MRA) in patients completing treatment in WA17822

EUCTR2005‐002909‐23‐ES

Long‐term extension study of safety during treatment with tocilizumab (MRA) in patients completing treatment in MRA core studies.

EUCTR2005‐003632‐22‐ES

A study of the pharmacokinetic and pharmacodynamic activity of rituximab in combination with methotrexate (MTX) in synovial tissue and in peripheral blood of patients with rheumatoid arthritis.

EUCTR2005‐004530‐40‐AT

Induction of remission in RA patients at low disease activity by additional infliximab‐therapy

EUCTR2005‐004582‐41‐GB

Safety and efficacy of combination treatment with rituximab and leflunomide in patients with active rheumatoid arthritis ‐ rituximab and leflunomide in RA

EUCTR2005‐005013‐37‐GB

A multi‐centre randomised double dummy double blind study comparing two regimens of combination induction therapy in early DMARD naive rheumatoid arthritis: the IDEA study (infliximab as induction therapy in early rheumatoid arthritis) ‐ IDEA

EUCTR2005‐005358‐27‐GB

Efficacy of rituximab (Mabthera) in active ankylosing spondylitis: a clinical and magnetic resonance imaging study ‐ rituximab in as

EUCTR2006‐000363‐28‐GB

Differentiating the mechanism of action of anti TNF‐alpha agents ‐ data study

EUCTR2006‐000854‐32‐AT

Rituximab in rheumatoid arthritis in patients who failed therapy with TNF‐blockers

EUCTR2006‐001000‐37‐DE

Efficacy and safety of rituximab in patients with rheumatoid arthritis ‐ FIRST

EUCTR2006‐001428‐38‐GB

Remission induction in very early rheumatoid arthritis (RIVERA): a comparison of etanercept plus methotrexate plus steroid with standard therapy ‐ RIVERA

EUCTR2006‐001553‐10‐BE

A 26‐week, phase II, multi‐center, randomized, double‐blind, placebo‐controlled study to assess the response to treatment (acr50) and to determine a biomarker profile in responders to ACZ885 (anti‐interleukin‐1beta monoclonal antibody) plus MTX as compared to MTX alone in early rheumatoid arthritis patients ‐ 2204

EUCTR2006‐003843‐22‐IT

Prospective study on intensive early rheumatoid arthritis treatment with adalimumab: induction of remission and maintenance ‐ 'CURE' A phase IV multicenter, randomized, double‐blind study

EUCTR2006‐004139‐31‐BE

A multicenter, randomized, double‐period, double‐blind study to determine the optimal protocol for treatment initiation with methotrexate and adalimumab combination therapy in patients with early rheumatoid arthritis ‐ OPTIMA

EUCTR2006‐004673‐98‐HU

Efficacy of rituximab treatment in patients with rheumatoid arthritis having inadequate response to TNF blocker

EUCTR2006‐005137‐38‐FR

A 3 month, randomised, open label, parallel group, descriptive study to explore and compare perceptions and satisfaction for two different delivery mechanisms for etanercept (etanercept autoinjector and the etanercept prefilled syringe)

EUCTR2006‐005157‐29‐FR

Effet du methotrexate sur la relation dose ‐ effet de l'infliximab dans la spondylarthrite ankylosante ‐ SPAXIM

EUCTR2006‐005386‐19‐BE

Cytokines and inflammatory proteins gene expression study in synovial biopsies from rheumatoid arthritis patients refractory to anti‐TNF therapy treated with rituximab ‐ anti TNF resistant RA / RTX / mini

EUCTR2006‐005640‐81‐GB

A placebo controlled study of the effect of extended treatment with rituximab on resistant rheumatoid arthritis: ‐ EXXTRA

EUCTR2006‐006127‐40‐GB

Cerebral blood flow following TNF‐alpha antagonism in rheumatoid arthritis ‐ a pilot study ‐ TNF/cbf in RA

EUCTR2006‐006186‐16‐NL

Improved: Induction therapy with methotrexate and prednisone in rheumatoid or very early arthritic disease a randomized clinical trial in patients with recent‐onset arthritis to compare the efficacy of DMARD combination therapy including prednisone with combination therapy including adalimumab, a TNF‐blocking agent ‐ IMPROVED

EUCTR2006‐006275‐21‐GB

A randomised, pragmatic, open‐label study of adalimumab versus etanercept for rheumatoid arthritis. ‐ adalimumab versus etanercept for RA

EUCTR2006‐006591‐37‐BE

A 3 month, randomised, open label, parallel group, descriptive study to explore and compare perceptions and satisfaction for two different delivery mechanisms for etanercept (etanercept auto‐injector and the etanercept prefilled syringe)

EUCTR2006‐006746‐33‐DE

Re‐treatment with rituximab in patients with rheumatoid arthritis who have had an inadequate response to not more than one a TNF (extension study to ML19070) ‐ efficacy of re‐therapy in anti‐TNFalpha IR

EUCTR2007‐000082‐38‐DK

The OPERA Study. Optimized treatment algorithm in early rheumatoid arthritis: Methotrexate and intra‐articular glucocorticosteroid plus adalimumab or placebo in the treatment of early rheumatoid arthritis. A Randomised, double‐blind and placebo‐controlled, two arms, parallel group study of the additive effect of adalimumab concerning inflammatory control and inhibition of erosive development. ‐ The OPERA Study

EUCTR2007‐000593‐24‐GB

An open‐label, observational study of the effects of anti‐TNF therapy on peripheral blood and synovial biomarkers in patients with active rheumatoid arthritis.

EUCTR2007‐000828‐40‐FR

A phase IIIb, multi‐centre, double‐blind randomized, placebo‐controlled, parallel group 52‐week study to evaluate safety and efficacy of the PEGylated anti‐TNFα Fab′fragment, certolizumab pegol, administered concomitantly with stable‐dose DMARDs in patients with moderate to low disease activity rheumatoid arthritis.

EUCTR2007‐000896‐41‐HU

A randomized, double‐blind study comparing the safety and efficacy of once‐weekly administration of etanercept 50 mg, etanercept 25 mg, and placebo in combination with methotrexate in subjects with moderately active rheumatoid arthritis

EUCTR2007‐001190‐28‐GB

Randomised controlled trial of tumour‐necrosis‐factor inhibitors against combination intensive therapy with conventional disease modifying anti‐rheumatic drugs in established rheumatoid arthritis ‐ TACIT

EUCTR2007‐001420‐12‐BE

A randomised, double‐blind (with open comparator etanercept limb), placebo‐controlled, phase IIb, multicentre study to evaluate the efficacy of 4 doses of azd9056 administered for 6 months on the signs and symptoms of rheumatoid arthritis

EUCTR2007‐001585‐33‐LT

A randomized, placebo controlled, multicenter clinical study investigating efficacy of rituximab (Mabthera®/Rituxan®) in the inhibition of joint structural damage assessed by magnetic resonance imaging in patients with rheumatoid arthritis and inadequate response to methotrexate ‐ the R.A. Score study. ‐ R.A. Score

EUCTR2007‐001625‐10‐HU

An open‐label, randomized study to evaluate the radiographic efficacy and safety of Enbrel™ (etanercept) added to methotrexate in comparison with usual treatment in subjects with moderate rheumatoid arthritis disease activity. ‐ EXTRA

EUCTR2007‐001754‐11‐IT

Pilot study to evaluate the effect of rituximab in combination with MTX in the inhibition of progression of synovitis, bone marrow edema, and erosions evaluated by magnetic resonance imaging (MRI) in the hand of patients with rheumatoid arthritis. ‐ nd

EUCTR2007‐002066‐35‐HU

A phase 2B, randomized, double‐blind, placebo controlled active comparator, multicenter study to compare 5 dose regimens of CP‐690,550 and adalimumab versus placebo, administered for 6 months in the treatment of subjects with active rheumatoid arthritis

EUCTR2007‐002536‐29‐FR

A randomised, double‐blind, placebo controlled, multi‐centre phase II study of atacicept in anti‐ TNF alfa‐naïve patients with moderate to severely active rheumatoid arthritis and an inadequate response to methotrexate ‐ atacicept in anti‐TNF alfa‐naïve subjects with RA

EUCTR2007‐003096‐39‐IT

Effects of etanercept on endothelial function and carotid intima‐media thickness in patients with active ankylosing spondylitis: a 52‐weeks, randomized, double blind, placebo‐controlled study ‐ crest

EUCTR2007‐003288‐36‐NL

A phase 4, multicenter, open‐label, assessor‐blinded, switch study of the efficacy and safety of infliximab (Remicade) in patients with active rheumatoid arthritis who are responding inadequately to etanercept (Enbrel) of adalimumab (Humira) ‐ restart

EUCTR2007‐003358‐27‐DE

Phase III, multi‐center, randomized, double blind, placebo‐controlled study for treatment of juvenile ankylosing spondylitis with adalimumab ‐ Humira Study

EUCTR2007‐003623‐20‐ES

Estudio de los efectos de la terapia anti‐célula b (rituximab) sobre la inmunopatología del tejido sinovial y las células b de sangre periférica en artritis reumatoide (estudio tesice‐ar). Study of the b‐cell‐targeted therapy (rituximab) effects on the synovial tissue inmunopathology and peripheral blood b cells in rheumatoid arthritis (tesice‐ar study).

EUCTR2007‐003647‐75‐NL

A randomised, double‐blind, placebo controlled, multi‐centre, exploratory, pilot, phase II trial of 150 mg atacicept given subcutaneously in combination with rituximab in subjects with rheumatoid arthritis. ‐ atacicept in combination with rituximab in subjects with rheumatoid arthritis

EUCTR2007‐004694‐26‐BE

A comparative study of a 6‐month infliximab (Remicade) or placebo regimen in undifferentiated arthritis at high risk for the development of rheumatoid arthritis : clinical, radiological (MRI) and synovial benefit p1200/001. ‐ infliximab (Remicade) in ua

EUCTR2007‐005464‐26‐GB

Development of heart and blood vessel problems in patients with conditions which cause long‐term, widespread, inflammation in the body.

EUCTR2007‐005905‐23‐DE

A multi‐center, randomized, double‐blind, placebo‐controlled study comparing 80 mg of adalimumab with placebo, and demonstrating the non‐inferiority of monthly 80 mg adalimumab dosing compared with 40 mg adalimumab every other week dosing

EUCTR2007‐006657‐63‐FI

Study comparing the effect on disease activity when reducing or discontinuing etanercept in subjects with rheumatoid arthritis (RA) (dosera)

EUCTR2007‐007539‐14‐CZ

A randomised, double‐blind, placebo‐controlled, phase IIb dose‐ranging study (with open‐label etanercept treatment group) to investigate efficacy, safety and pharmacokinetics of azd5672 administered for 12 weeks to rheumatoid arthritis patients receiving

EUCTR2008‐000105‐11‐DE

Effectiveness after 4 and 24 weeks and safety of tocilizumab in patients with active RA ‐ TAMARA ‐ tocilizumab and DMARDs: achievements in rheumatoid arthritis

EUCTR2008‐000587‐17‐GB

Multi‐national open‐label study to evaluate the safety, tolerability and efficacy of tocilizumab in patients with active rheumatoid arthritis on background non‐biologic DMARDs who have an inadequate response to current non‐biologic DMARD and/or anti‐TNF therapy

EUCTR2008‐001241‐26‐HU

A randomized, placebo‐controlled, double‐blind, dose escalation study to evaluate the efficacy, safety and tolerability of the study drug bt971 in patients with rheumatoid arthritis receiving concomitant methotrexate ‐ n.a.

EUCTR2008‐002381‐55‐ES

Evaluación de la eficacia de rituximab en pacientes con artritis reumatoide a través de la medición, por resonancia magnética de mano, de los parámetros clínicos de la enfermedad. Estudio resonar. Efficacy of rituximab in patients with rheumatoid arthritis, by measurement of disease parameters through magnetic resonance of the hand. RESONAR study.

EUCTR2008‐002623‐85‐NL

A 3‐phase study to evaluate sustained remission and productivity outcomes in subjects with early rheumatoid arthritis initiated on treatment with etanercept plus methotrexate

EUCTR2008‐002631‐33‐GB

Randomized, placebo controlled, double blind, multi‐center phase II proof‐of‐concept study to assess the efficacy of ain457 in patients with moderate to severe ankylosing spondylitis ‐ cain457a2209

EUCTR2008‐003011‐12‐GB

Prospective randomised double‐blind placebo controlled study assessing the efficacy of tocilizumab with synovial analysis in patients with rheumatoid arthritis ‐ TOCRA

EUCTR2008‐004126‐16‐FI

Local open‐label study to evaluate the safety and efficacy of tocilizumab in patients with active rheumatoid arthritis on background non‐biologic DMARDs who have an inadequate response to current non‐biologic DMARDs

EUCTR2008‐004931‐39‐PL

A study to determine the safety, efficacy, and pharmacokinetics of 80 mg, 160 mg, and 320 mg ald518 versus placebo administered as multiple intravenous infusions to patients with active rheumatoid arthritis who have had an inadequate response to methotrexate.

EUCTR2008‐005212‐40‐SE

Pain mechanisms and fatigue in rheumatoid arthritis (RA) and healthy volunteers. Can antirheumatic and biological therapy affect pain processing and fatigue in RA? ‐ RA pain processing

EUCTR2008‐005320‐81‐AT

A 2‐year open‐label second extension study to evaluate the safety, tolerability and efficacy of canakinumab (acz885) an anti‐interleukin‐1ß monoclonal antibody in patients with active rheumatoid arthritis ‐ a2201e2

EUCTR2008‐005450‐20‐BE

The cost‐effectiveness of abatacept, rituximab or anti‐TNF alpha for patients with rheumatoid arthritis. ‐ Dutch Rheumatoid Arthritis Monitoring (DREAM) Targetted Immune Modulator Evaluation (TIME)

EUCTR2008‐005525‐11‐ES

Estudio randomizado, controlado con placebo, doble ciego y con grupos paralelos para comparar la seguridad y la reducción de la actividad de la enfermedad con la combinación de rituximab (Mabthera) y tocilizumab (roactemra) frente al tratamiento con tocilizumab en pacientes con artritis reumatoide activa con respuesta incompleta a metotrexato. A randomized, placebo controlled, double‐blind, parallel group study to compare the safety and efficacy of the combination of rituximab (Mabthera) and tocilizumab (Actemra) versus tocilizumab therapy in patients with active rheumatoid arthritis with an incomplete response to methotrexate.

EUCTR2008‐006256‐22‐FR

Evaluation by high resolution micro computerized tomography of bone microarchitecture changes in patients with rheumatoid arthritis under anti‐TNF therapy.

EUCTR2008‐006885‐27‐NL

Efficacy and safety of adalimumab (Humira®) in patients with peripheral spondyloarthritis without ankylosing spondylitis or psoriatic arthritis

EUCTR2008‐006924‐68‐AT

Extension phase of the multi‐national open‐label study to evaluate the safety, tolerability and efficacy of tocilizumab in patients with active rheumatoid arthritis on background non‐biologic DMARDs who have an inadequate response to current non‐biologic DMARD and/or anti‐TNF therapy. ‐ this is an extension study to MA21573

EUCTR2008‐006936‐37‐HU

A randomized, parallel, double‐blind, placebo‐controlled study to evaluate the efficacy and safety of ILV‐094 administered subcutaneously to subjects with active rheumatoid arthritis on a stable background of methotrexate

EUCTR2008‐008338‐35‐CZ

Phase 3 randomized, double‐blind, active comparator, placebo‐controlled study of the efficacy and safety of 2 doses of CP 690,550 in patients with active rheumatoid arthritis on background methotrexate

EUCTR2009‐010582‐23‐DE

A golimumab phase 3b, multicenter, switch assessment of subcutaneous and intravenous efficacy in rheumatoid arthritis patients who have inadequate disease control despite treatment with etanercept (Enbrel®) or adalimumab (Humira®)

EUCTR2009‐010955‐29‐NL

Prevention of clinically manifest rheumatoid arthritis by B cell directed therapy in the earliest phase of the disease.

EUCTR2009‐011105‐17‐IT

A single‐arm, open‐label study of early improvement of anemia and fatigue during treatment with tocilizumab (TCZ) in combination with non biologic DMARDs, in adult patients with moderate to severe active rheumatoid arthritis. ‐ anemia fatigue

EUCTR2009‐011137‐26‐DE

An open‐label study assessing the addition of subcutaneous golimumab (GLM) to conventional disease‐modifying antirheumatic drug (DMARD) therapy in biologic‐naïve subjects with rheumatoid arthritis (part 1), followed by a randomized study assessing the val

EUCTR2009‐011520‐53‐SK

Evaluation of adherence and persistence to tocilizumab in combination with methotrexate or tocilizumab monotherapy in patients with moderate to severe active rheumatoid arthritis in local environment

EUCTR2009‐011591‐30‐GB

An open‐label non‐randomized extension study to evaluate the safety and tolerability of ain457 (anti interleukin‐17 monoclonal antibody) in patients with moderate to severe ankylosing spondylitis ‐ a2209e1

EUCTR2009‐011719‐19‐FR

Phase 3, multicenter, randomized, double‐blind, placebo‐controlled study to evaluate efficacy and safety of certolizumab pegol in subjects with active axial spondyloarthritis (axial spa)

EUCTR2009‐012185‐32‐IT

Open label, multicentric phase IIIb study to evaluate the effect of tocilizumab in combination with DMARDs in the inhibition of progression of synovitis, bone marrow edema, and erosions evaluated by dedicated magnetic resonance imaging (MRI) in the hand of patients with rheumatoid arthritis (RA) ‐ ND

EUCTR2009‐012204‐42‐IE

A randomized, double‐blind, placebo‐controlled, parallel group study to investigate the ability of gsk706769 to maintain clinical efficacy after withdrawal of Enbrel in patients with rheumatoid arthritis

EUCTR2009‐012218‐30‐PT

A randomized, double‐blind, placebo‐controlled study to assess the efficacy of tocilizumab (TCZ) + non‐biological DMARD in reducing synovitis as measured by magnetic resonance imaging (MRI) at 12 weeks after initiation of treatment in patients with moderate to severe rheumatoid arthritis (RA) with inadequate response to non‐biological DMARDs ‐ portrait

EUCTR2009‐012759‐12‐GB

A multi‐center, randomized, double‐blind, parallel group study of the safety, disease remission and prevention of structural joint damage during treatment with tocilizumab (TCZ), as a monotherapy and in combination with methotrexate (MTX), versus methotrexate in patients with early, moderate to severe rheumatoid arthritis.

EUCTR2009‐013316‐12‐NL

A multi‐center, randomized, double blind, placebo controlled study to evaluate remission in DMARD and biological naïve early rheumatoid arthritis (RA) subjects treated with tocilizumab (TCZ) plus tight control methotrexate (MTX) treatment, TCZ monotherapy or tight control MTX monotherapy. ‐ U‐ACT‐EARLY

EUCTR2009‐013758‐33‐SE

Multicenter study with a 16‐week double‐blind, placebo‐controlled (during the initial 2 weeks) randomized period, followed by a 24‐week open label extension to assess magnetic resonance image‐verified early response to certolizumab pegol in subjects with

EUCTR2009‐015515‐40‐NL

Prevention of the progression of very early symptoms into ankylosing spondylitis: a placebo controlled trial with etanercept ‐ prevas

EUCTR2009‐015653‐20‐NL

Prospective study on the effects of etanercept treatment in patients with rheumatoid arthritis who are naïve for TNF‐alpha blocking therapy and patients who do not respond (anymore) to prior treatment with other anti‐TNF‐alpha medication ‐ not applicable

EUCTR2009‐015740‐42‐DE

A phase 3, multicenter, randomized, open, prospective, controlled, parallel‐group study of reduction of therapy in patients with rheumatoid arthritis in ongoing remission RETRO – reduction of therapy in RA patients in ongoing remission, reduzierung der therapie bei RA‐patienten in remission ‐ RETRO

EUCTR2009‐015845‐21‐GB

A multi‐center, randomized, blinded, parallel‐group study of the reduction of signs and symptoms during monotherapy treatment with tocilizumab 8 mg/kg intravenously versus adalimumab 40 mg subcutaneously in patients with rheumatoid arthritis

EUCTR2009‐015950‐39‐DE

Rituximab‐treatment in addition to leflunomide in patients with active rheumatoid arthritis

EUCTR2009‐016789‐10‐NL

Efficacy of the H1N1 flu (swine flu) vaccination in patients with rheumatoid arthritis treated with rituximab

EUCTR2009‐017325‐19‐FI

The effect of six months adalimumab treatment on sick leaves and retirement in patients with rheumatoid arthritis who are at risk of losing their ability to work

EUCTR2009‐017443‐34‐GB

A ph II/III seamless, multi‐center, randomized, double‐blind, placebo‐controlled study of the reduction in signs and symptoms and inhibition of structural damage during treatment with tocilizumab versus placebo in patients with ankylosing spondylitis who have failed non‐steroidal anti‐inflammatory drugs and are naïve to TNF antagonist therapy

EUCTR2009‐017488‐40‐GB

A randomized, double‐blind, parallel‐group placebo‐controlled study of the safety and reduction of signs and symptoms during treatment with tocilizumab (TCZ) versus placebo in patients with ankylosing spondylitis who have had an inadequate response to previous TNF antagonist therapy

EUCTR2010‐018331‐18‐GB

A 52 week, single center, open‐label study to evaluate neutrophil function and survival effects of tocilizumab (TCZ) in patients with active rheumatoid arthritis (RA) on background non‐biologic DMARDs who have an inadequate response to current non‐biologic DMARD and/or anti‐TNF therapy

EUCTR2010‐018375‐22‐ES

A randomized, double‐blind, parallel group study of the safety and effect on clinical outcome of tocilizumab sc versus tocilizumab iv, in combination with traditional disease modifying anti‐rheumatoid arthritis drugs (DMARDs), in patients with moderate to severe active rheumatoid arthritis. Estudio randomizado, doble ciego, con grupos de tratamiento paralelos, para evaluar la seguridad y el efecto sobre el resultado clínico de tocilizumab sc frente a tocilizumab iv en combinación con fármacos antirreumáticos modificadores de la enfermedad (FAMEs) tradicionales, en pacientes con artritis reumatoide activa moderada a severa.

EUCTR2010‐018646‐31‐LV

Recruitment status

EUCTR2010‐019694‐15‐BE

Act‐alone : an open‐label, single‐arm study to describe glucocorticoid use in rheumatoid arthritis patients treated with tocilizumab in daily clinical practice and to evaluate systematic glucocorticoid dose reduction once low disease activity is reached ‐ act‐alone

EUCTR2010‐019873‐13‐BE

Comparative study of the clinical response and cardiorespiratory endurance in early rheumatoid arthritis patients treated with tociluzimab or methotrexate addendum protocol : global gene expression profiles in synovial biopsies from early rheumatoid arthritis patients treated with tocilizumab or methotrexate ‐TOMERA

EUCTR2010‐019935‐37‐FI

A pragmatic, randomized, parallel group study of the effect on disease remission, work productivity, and tolerability of tocilizumab in combination with DMARDs and individually designed best practice DMARD therapy in patients with early, moderate to severe rheumatoid arthritis

EUCTR2010‐020738‐24‐GB

To see whether for patients with established rheumatoid arthritis that have already achieved a good response to tumour necrosis factor inhibitor (TNF inhibitor) treatment, whether the treatment be tapered to a minimum dose without affecting the control of disease activity

EUCTR2010‐020839‐39‐GB

Efficacy and safety of cdp6038 in patients with rheumatoid arthritis with an unsuccessful response to anti‐TNF therapy

EUCTR2010‐020913‐10‐GB

An open label, pilot, multi‐centre, step‐down, randomised controlled trial to examine whether etanercept 25mg once weekly is effective in maintaining a clinical response in patients with ankylosing spondylitis who have responded to 50mg once weekly ‐ answ

EUCTR2010‐021020‐94‐DE

A randomized, double‐blind, parallel‐group, placebo‐ and active calibrator‐controlled study assessing the clinical benefit of sar153191 subcutaneous (sc) on top of methotrexate (MTX) in patients with active rheumatoid arthritis (RA) who have failed previo text missing here ‐ title incomplete

EUCTR2010‐022049‐88‐DE

"Efficacy and safety study of a sequential therapy of tocilizumab (TCZ) and, if initially inadequately responded to tocilizumab (TCZ), followed by rituximab (RTX) in DMARD‐ir patients with rheumatoid arthritis (MIRAI)" ‐ MIRAI

EUCTR2010‐022378‐15‐DE

A clinical study to explore the therapeutic effects of different doses of the new drug veltuzumab, a drug of biologic origin, and placebo, in patients with rheumatoid arthritis.

EUCTR2010‐023910‐30‐GB

A prospective, single‐centre, randomised study evaluating the clinical, imaging and immunological depth of remission achieved by very early versus delayed etanercept in patients with rheumatoid arthritis (VEDERA) ‐ very early versus delayed etanercept in

EUCTR2010‐023956‐99‐HU

Phase IIB rheumatoid arthritis dose ranging study for BMS‐945429 in subjects who are not responding to methotrexate

EUCTR2011‐000215‐79‐FR

Tociluzimab effect on endothelial function in patients with rheumatoid arthritis ‐ TEFRA

EUCTR2011‐001626‐15‐ES

A study of Roactemra/Actemra (tocilizumab) in combination with methotrexate in patients with rheumatoid arthritis with inadequate response to prior treatment with methotrexate and low disease activity with the combination de Roactemra/Actemra y methotrexate.

EUCTR2011‐001729‐25‐DE

Study designed to demonstrate the efficacy and safety of certolizumab pegol in combination with methotrexate in the treatment of subjects suffering from early, progressive active rheumatoid arthritis.

EUCTR2011‐001863‐39‐AT

A study of safety and efficacy of tocilizumab (TCZ) in combination with methotrexate (MTX) versus tocilizumab monotherapy in patients with mild to moderate rheumatoid arthritis, who have not adequately responded to their current treatment with MTX.

EUCTR2011‐002275‐41‐CZ

A study of two different adalimumab formulations in adults with rheumatoid arthritis

EUCTR2011‐002325‐22‐GB

Study of ixekizumab in participants with active ankylosing spondylitis (AS)

EUCTR2011‐002363‐15‐IS

A clinical trial with the aim to explore infusion reactions from tocilizumab given either in 31 or 60 minutes to patients with moderate to severe rheumatoid arthritis.

EUCTR2011‐004017‐17‐GB

Tocilizumab and remission in early rheumatoid arthritis

EUCTR2011‐004171‐36‐CZ

A study comparing sait101 to Mabthera® in subjects with severe rheumatoid arthritis (RA)

EUCTR2011‐004468‐31‐GB

Evaluating the long‐term safety and efficacy effects of ct‐p13 together with methotrexate in patients with arthritis

EUCTR2011‐005021‐48‐HU

A study to investigate and compare the efficacy, safety, tolerability and pharmacodynamic (biochemical and physiological effects of the drug) of tl011 and Mabthera® (rituximab) in patients with severe, active rheumatoid arthritis treated with methotrexate (MTX)

EUCTR2011‐005204‐15‐AT

Could ultrasound help to identify the patients with rheumatoid arthritis, in those the treatment with biological DMARDs could be stopped?

EUCTR2011‐005260‐20‐GB

Roactemra® (tocilizumab) plus methotrexate (MTX) in stable dosage in comparison with Roactemra® plus reducing (tapering) MTX dosages in patients with severe rheumatoid arthritis (RA) that have inadequate responded to a trial of two disease modifying anti‐rheumatic drugs (DMARDs), including MTX and have not been previously treated with a biologic agent, such as a TNF inhibitor.

EUCTR2011‐005448‐87‐HU

A study of the maintenance of efficacy of etanercept plus DMARD(s) compared with DMARD(s) alone in subjects with rheumatoid arthritis after achieving an adequate response with etanercept plus DMARD(s)

EUCTR2011‐005649‐10‐DE

An exploratory clinical study to investigate mavrilimumab, an antibody being developed for the treatment of moderate to severe rheumatoid arthritis, an inflammatory condition that affects the joints versus a different antibody whose mechanism works by inh

EUCTR2011‐006001‐10‐IT

Efficacy of rituximab at the dose of 500 mg e.v., two infusions two weeks apart, versus rituximab at the usual dose of 1000 mg, two infusions two weeks apart, in patients affected by rheumatoid arthritis, who had been previously treated with rituximab at the standard dose for at least two cycles obtaining a good clinical response

EUCTR2011‐006040‐79‐DK

A clinical trial with the aim to explore the efficacy and safety of adding tocilizumab to standard of care in patients with early rheumatoid arth ‐ please add missing text

EUCTR2011‐006125‐14‐HU

A multicenter, open‐label, single arm, long term extension study of WA19926 to describe safety during treatment with tocilizumab in patients with early, moderate to severe rheumatoid arthritis ‐ function LTE

EUCTR2012‐000139‐21‐AT

Multi‐center biomarker trial to predict therapeutic responses of patients with rheumatoid arthritis to a specific biologic mode of action

EUCTR2012‐001760‐30‐IT

Evaluation effects of treatment with an inhibitor of the receptor of a protein (interleukin‐6 il‐6)involved in inflammatory process, on the clinical response and on the changes from baseline in the biomarkers in patients with rheumatoid arthritis (RA)not responding adequately to disease‐modifying antirheumatic drugs (DMARDs) and/or to a first biological agent.

EUCTR2012‐002009‐23‐HU

Clinical trial to demonstrate that treatments with gp2015 and Enbrel® are comparable in patients with rheumatoid arthritis

EUCTR2012‐002322‐73‐HU

A phase 3 study in moderate to severe rheumatoid arthritis

EUCTR2012‐002535‐28‐GB

A randomised, open labelled study in anti‐TNFa inadequate responders to investigate the mechanisms for response ‐ resistance to rituximab versus tocilizumab in RA (r4‐ra) ‐ r4‐ra

EUCTR2012‐003057‐29‐CZ

A multi‐centre, randomised, double‐blind multiple dose study of increasing doses of xmab5871 in patients with rheumatoid arthritis.

EUCTR2012‐003194‐25‐LT

Bioequivalence trial of Mabioncd20® (Mabion SA) compared to reference product: Mabthera® (rituximab, Roche) in patients with rheumatoid arthritis

EUCTR2012‐003536‐23‐CZ

To evaluate the safety of sar153191 (REGN88) and tocilizumab added to other RA drugs in patients with RA who are not responding to or intolerant of anti‐TNF therapy (Saril‐RA‐Ascertain)

EUCTR2012‐003644‐71‐ES

Randomized, double‐blind, placebo‐controlled trial of etanercept plus methotrexate in monoclonal antibody (MAB) anti‐TNF failure

EUCTR2012‐003876‐38‐DE

Clinical study to find out if the biologically similar medicine gp2013 is safe in patients with rheumatoid arthritis who have been treated with Rituxan® or Mabthera® in the past

EUCTR2012‐004482‐40‐ES

Evaluation of a protocol for the reduction of doses in patients with rheumatoid arthritis (RA) in clinical remission in treatment with biological therapies

EUCTR2012‐005026‐30‐HU

A study comparing SB4 to Enbrel® in subjects with moderate to severe rheumatoid arthritis despite methotrexate therapy

EUCTR2012‐005275‐14‐NO

Remission in rheumatoid arthritis – assessing withdrawal of disease‐modifying antirheumatic drugs

EUCTR2012‐005733‐37‐CZ

A study comparing SB2 to Remicade® in subjects with moderate to severe rheumatoid arthritis

EUCTR2013‐000337‐13‐DE

Prediction of response to certolizumab pegol treatment with MRI of the brain. A multi‐center, randomized double‐blind controlled study prediction of response to certolizumab‐pegol in rheumatoid arthritis (PRECEPRA)

EUCTR2013‐000342‐19‐NL

A clinical trial where patients with rheumatoid arthritis are treated with the study drug tocilizumab, subcutaneous (injection in the skin), with or without other non‐biological anti‐rheumatic drugs, to study the safety and efficacy of the drug.

EUCTR2013‐000525‐31‐GB

A randomized, double‐blind, phase 3 Study of ABP 501 efficacy and safety compared to adalimumab in subjects with moderate to severe rheumatoid arthritis

EUCTR2013‐001569‐17‐IT

A national, open‐label, single‐arm, phase IIIb study to evaluate the efficacy of weekly tocilizumab subcutaneous, administered as monotherapy or in combination with other non‐biological medicinal products in rheumatoid arthritis (RA) patients.

EUCTR2013‐002007‐34‐FI

Safety and efficacy study of tocilizumab injected under the skin in patients with active rheumatoid arthritis (RA) and inadequate response to disease modifying antirheumatic drugs.

EUCTR2013‐002150‐79‐BE

A study to evaluate the efficacy and safety of tocilizumab subcutaneous in RA patients

EUCTR2013‐002429‐52‐ES

Study to evaluate the efficacy, safety and tolerability of subcutaneous (SC) tocilizumab (TCZ) in subjects with rheumatoid arthritis

EUCTR2013‐002777‐22‐GB

Targeted Ultrasound in Rheumatoid Arthritis (TURA)

EUCTR2013‐003177‐99‐SE

A clinical study to evaluate the safety of two different doses of tofacitinib for the treatment of rheumatoid arthritis.

EUCTR2013‐003413‐18‐GB

Arthritis prevention with abatacept

EUCTR2013‐004051‐20‐ES

Not controlled study to assess the efficacy of tocilizumab in patients with moderate or severe rheumatoid arthritis who are candidates to be treated with a biological therapy as monotherapy

EUCTR2013‐004148‐49‐LT

Randomized study of pf‐06438179 and infliximab in combination with methotrexate in subjects with moderately to severely active rheumatoid arthritis

EUCTR2013‐004555‐21‐AT

A randomized, controlled, double‐blind, parallel‐group, phase 3 study to compare the pharmacokinetics, efficacy and safety between ct‐p10, Rituxan and Mabthera in patients with rheumatoid arthritis

EUCTR2013‐005543‐90‐HU

A randomized, double‐blind study to compare pharmacokinetics and pharmacodynamics, efficacy and safety of ABP 798 with rituximab in subjects with moderate to severe rheumatoid arthritis

EUCTR2014‐000109‐11‐DE

Study to assess the efficacy and safety of FKB327 compared with Humira®, when each is administered in combination with methotrexate in patients with rheumatoid arthritis

EUCTR2014‐000110‐61‐CZ

Study to assess the long‐term efficacy and safety of FKB327 compared with Humira®, when each is administered in combination with methotrexate in patients with rheumatoid arthritis

EUCTR2014‐002374‐36‐SE

A study with dose de‐escalation of conventional or biologic treatments in early rheumatoid arthritis in patients with low disease activity.

EUCTR2014‐002945‐23‐GB

A 24‐week randomized, open‐label, parallel‐group, active‐controlled, exploratory, proof‐of‐mechanism imaging study investigating the efficacy of 150 mg of namilumab administered subcutaneously vs adalimumab in patients with moderate to severe early rheumatoid arthritis inadequately responding to methotrexate ‐ a phase 2 study of namilumab vs anti‐tumor necrosis factor in patients with rheumatoid arthritis

EUCTR2014‐003255‐54‐CZ

A study evaluating the effects of rgb‐03 and Mabthera combined with methotrexate in patients with rheumatoid arthritis

EUCTR2014‐003307‐30‐HU

Multiple dose study of ucb4940 as add‐on to certolizumab pegol in subjects with rheumatoid arthritis

EUCTR2014‐003453‐34‐EE

Study of a new drug’s effect in people with rheumatoid arthritis who have not responded sufficiently well to treatment with methotrexate.

EUCTR2014‐003529‐16‐GB

Stratification of biologic therapies for rheumatoid arthritis by pathobiology

EUCTR2014‐004558‐33‐Outside‐EU/EEA

A multicenter, open‐label study of the safety, efficacy, and pharmacokinetics of the human anti‐TNF monoclonal antibody adalimumab in children with polyarticular juvenile rheumatoid arthritis

EUCTR2014‐004673‐16‐DE

Randomized, blinded, controlled study to compare the efficacy of treatment with tocilizumab with or without glucocorticoids in rheumatoid arthritis.

EUCTR2014‐004704‐29‐ES

This trial is designed to determine what effects the human body has on the investigational medicine, ABP 710, and what effects the body has on the investigational medicine after you have been given it, and if this is comparable to what is seen for the licensed medicine, infliximab, in patients with moderate or severe rheumatoid arthritis (RA). This study will assess if the investigational medicine is safe and effective in treating moderate or severe RA compared to the licensed medicine.

EUCTR2014‐004868‐38‐GR

A study comparing the use of etanercept and methotrexate, used either alone or in combination, for maintaining remission in rheumatoid arthritis.

EUCTR2014‐004904‐31‐NL

A clinical study to investigate the infliximab serum concentration of Remsima™ (infliximab biosimilar) after switching from Remicade (infliximab) in subjects with Crohn’s disease (CD), ulcerative colitis (UC) or rheumatoid arthritis (RA) in stable remission.

EUCTR2014‐005368‐13‐HU

A study comparing sait101 to Mabthera® or Rituxan® in patients with rheumatoid arthritis (RA)

EUCTR2015‐000581‐58‐CZ

A randomized,biomarker trial to predict therapeutic responses of patients with rheumatoid arthritis to a specific biologic mode of action

EUCTR2015‐001246‐28‐BE

Ultrasound scores as imaging biomarkers of early response to subcutaneous tocilizumab in association with methotrexate in early rheumatoid arthritis (TOVERA study)

EUCTR2015‐001894‐41‐HU

Multicenter study to evaluate efficacy and safety of certolizumab pegol in subjects with active inflammation in the spine with no damage on x‐rays.

EUCTR2015‐002284‐42‐FI

The rationale for this study is to gain insight in the extent and impact of immunogenicity of TNF inhibitors in the European daily clinical practice. Furthermore, an European wide database will give insight in factors influencing immunogenicity and treatment outcome in terms of disease activit

EUCTR2015‐002466‐22‐Outside‐EU/EEA

A randomized, multi‐center, blinded, placebo‐controlled study with an openlabel run‐in period to evaluate the efficacy, safety, and pharmacokinetics of daily, single, subcutaneous injections of r‐methuil‐1ra (anakinra) in polyarticular‐course juvenile rhe

EUCTR2015‐002809‐12‐HU

A study to compare ylb113 and Enbrel for the treatment of rheumatoid arthritis

EUCTR2015‐003433‐10‐CZ

ADMYRA Trial: clinical trial to compare treatment with GP2017 and Humira® in patients with rheumatoid arthritis

EUCTR2015‐004386‐91‐PL

Study to explore and compare the effects of a new drug in combination with methotrexate therapy in people with early and established rheumatoid arthritis.

EUCTR2015‐004858‐17‐NL

Remission induction in very early rheumatoid arthritis

EUCTR2015‐005307‐83‐CZ

Study of the efficacy and safety of Olokizumab in patients with moderately to severely active rheumatoid arthritis inadequately controlled by methotrexate therapy

EUCTR2016‐000933‐37‐HU

Study to compare abt‐494 to abatacept in subjects with rheumatoid arthritis on stable dose of conventional synthetic disease‐modifying antirheumatic drugs (csDMARDs) who have an inadequate response or intolerance to biologic DMARDs (select‐choice)

EUCTR2016‐002125‐11‐LV

Evaluating efficacy, pharmacokinetics and safety between subcutaneous CT‐P13 and intravenous CT‐P13 in patients with active rheumatoid arthritis

EUCTR2016‐002852‐26‐HU

MSB11022 in moderately to severely active rheumatoid arthritis

EUCTR2016‐002908‐15‐NL

Redo study: research into the effects of lower doses rituximab in patients with rheumatoid arthritis

IRCT201206266302N3

Comparative analysis of Altebrel® (aryogen) with Enbrel®

IRCT2014090319025N1

Efficacy of Mabasia (adalimumab) in rheumatoid arthritis

IRCT2015030321315N1

The effect of adalimumab on treatment of rheumatoid arthritis

ISRCTN14909030

Rituximab in rheumatoid arthritis: is a reduced dose every 6 months equally effective as the regular dose if the patient has low or very low disease activity?

ISRCTN15819795

Effect of anakinra (soluble interleukin‐1 receptor antagonist) as combination therapy: second uk combination therapy in early rheumatoid arthritis

ISRCTN23348591

A placebo controlled study of the effect of extended treatment with rituximab on resistant rheumatoid arthritis: clinical and radiological outcomes

ISRCTN27093749

Rituximab in rheumatoid arthritis in patients who failed therapy with tumour necrosis factor‐blockers: a multi‐centre clinical observational real‐life study (phase IIIb)

ISRCTN29665463

A placebo‐controlled trial of anti‐TNFa chimeric monoclonal antibody (infliximab, Remicade) in the modification of vascular disease markers in active rheumatoid arthritis

ISRCTN36745608

A controlled randomised double‐blind multicentre study comparing two therapy strategies in disease modifying anti‐rheumatic drug‐naive early rheumatoid arthritis patients over 48 weeks: induction therapy with adalimumab and methotrexate over 24 weeks followed by methotrexate monotherapy up to week 48 versus methotrexate monotherapy

ISRCTN39045408

Anti‐tumour necrosis factor (anti‐TNF) therapy over two years increases body fat mass in early rheumatoid arthritis

ISRCTN44880063

Differentiating the mechanism of action of anti‐TNF alpha agents

ISRCTN46017566

Arthritis prevention in the pre‐clinical phase of rheumatoid arthritis with abatacept

ISRCTN48638981

A multicentre randomised double‐blind placebo‐controlled study comparing two regimens of combination induction therapy in early disease‐modifying anti‐rheumatic drug naïve rheumatoid arthritis

ISRCTN49682259

Remission induction in very early rheumatoid arthritis: a comparison of etanercept plus methotrexate plus steroid with standard therapy

ISRCTN51200229

Randomised double blind trial of safety of anti‐tumour necrosis factor (anti‐TNF) chimeric monoclonal antibody (infliximab) in combination with methatrexate compared to methatrexate alone in patients with rheumatoid arthritis on standard disease modifying anti‐rheumatic drugs

ISRCTN57761809

Effect of anti‐tumour necrosis factor alpha (TNFa) therapy on blood vessel health in patients with rheumatoid arthritis

ISRCTN62900439

Leflunomide or methotrexate plus subcutaneous tumour necrosis factor‐alpha (TNF‐alpha) blocking agents in rheumatoid arthritis

ISRCTN70800019

Effects on tocilizumab drug therapy on fat tissue proteins in rheumatoid arthritis

ISRCTN75505683

Remission induction study in early rheumatoid arthritis (RA)

ISRCTN82317088

Changes in bone density and bone turnover in patients with rheumatoid arthritis treated with rituximab, a b cell depleting antibody

ISRCTN89222125

Switching to alternative tumour‐necrosis factor (TNF)‐blocking drugs or abatacept or rituximab in patients with rheumatoid arthritis who have failed an initial TNF‐blocking drug

ISRCTN95861172

Randomised efficacy and discontinuation study of etanercept and adalimumab (RED SEA): A pragmatic open label study in rheumatoid arthritis

ISRCTN97686858

A randomized, controlled study of intra‐articular injections of etanercept or glucocorticosteroids in patients with rheumatoid arthritis

JPRN‐JapicCTI‐111620

A randomized, double‐blind, phase I/II study of CT‐P13 compared with Remicade in patients with rheumatoid arthritis

JPRN‐JapicCTI‐142505

Phase III study of MRA‐SC 162 mg/week

JPRN‐JapicCTI‐142621

Chs‐0214 phase III trial

JPRN‐UMIN000000512

Efficacy of tacrolimus in rheumatoid arthritis patients who have been treated unsuccessfully with infliximab and methotrexate

JPRN‐UMIN000001240

The efficacy of tocilizumab to patients with rheumatoid arthritis refractory to anti‐TNF agents: the open trial

JPRN‐UMIN000001407

The efficacy and safety of the new biologic agents (humanized anti‐human interlukin‐6 receptor monoclonal antibody) on abnormal lipid metabolism and atherosclerosis for rheumatoid arthritis patients in Japan

JPRN‐UMIN000001798

Prevention of cartilage destruction in rheumatoid arthritis by etanercept (PRECEPT study)

JPRN‐UMIN000002110

Discontinuation of infliximab therapy after acquisition of low disease activity by infliximab in rheumatoid arthritis study: RRR (remission induction by Remicade) study

JPRN‐UMIN000002246

Study for predictors of effectiveness in tocilizumab therapy (PETITE)

JPRN‐UMIN000002340

Comparison of effects between higher dosages of infliximab and switching to other biologics for rheumatoid arthritis patients with less responsiveness to infliximab therapy (Chamlet)

JPRN‐UMIN000002421

Multicenter, open‐label parallel‐groups study comparing tocilizumab versus conventional treatment in rheumatoid arthritis with the complication of aa amyloidosis

JPRN‐UMIN000002687

Enbrel clinical outcome in RA patients for growing evidence

JPRN‐UMIN000002744

Success of tocilizumab in RA patients with remission induction and sustained efficacy after discontinuation

JPRN‐UMIN000003344

Induction of the remission by use of infliximab in RA

JPRN‐UMIN000003880

Keeping cartilagious quality by adalimumab in patient with rheumatoid arthritis in Kansai area

JPRN‐UMIN000004412

Corticosteroid‐sparing effect of Actemra in patients with rheumatoid arthritis refractory to anti‐TNF agents, methotrexate and corticosteroid

JPRN‐UMIN000005113

Evaluation of the clinical remission and its sustainment after discontinuation of infliximab in patients with rheumatoid arthritis who receive "programmed" treatment in randomized controlled trial

JPRN‐UMIN000005590

Maintenance of remission by tocilizumab mono‐therapy after remission obtained by combination with methotrexate in patients with rheumatoid arthritis

JPRN‐UMIN000006914

Postmarketing surveillance for investigating success in achieving clinical and functional remission and sustaining efficacy with tocilizumab in biologics naive RA patients

JPRN‐UMIN000006956

Efficacy and safety of tocilizumab in RA patients in daily clinical practice: an retrospective observational study

JPRN‐UMIN000007019

Efficacy and safety of tocilizumab mono‐therapy in patients with adult‐onset still's disease

JPRN‐UMIN000007086

An observational study for investigating success in achieving clinical, structural and functional remission and sustaining efficacy with tocilizumab

JPRN‐UMIN000007380

Comparison of the effects of single high‐dose methotrexate and methotrexate‐tocilizumab therapy on rheumatoid arthritis

JPRN‐UMIN000007432

Prospective research of infliximab treatment in active RA patients refractory to anti‐interleukin six receptor monoclonal antibody.

JPRN‐UMIN000007539

Follow‐up study of patients with rheumatoid arthritis who treated infliximab for 1 year and did not reach a clinical remission in rrrr study

JPRN‐UMIN000007786

"Effect examination of infliximab to the effect insufficient example and the example of effect decrease of the 1st TNF inhibitor in rheumatoid arthritis "

JPRN‐UMIN000007806

The feasibility study of accelated infliximab infusion during maintenance phase

JPRN‐UMIN000008185

Pilot study on the efficacy and safety of low‐dose tocilizumab therapy in elderly RA patients

JPRN‐UMIN000008281

Dose‐escalation study of infliximab or methotrexate based on the disease activity in patients with rheumatoid arthritis treated with infliximab

JPRN‐UMIN000008404

Extension of tocilizumab dose intervals in patients with low to moderate disease activity rheumatoid arthritis using il‐6 serum level as starting criteria.

JPRN‐UMIN000008572

The kitasato institute non‐inferiority trial of etanercept and tacrolimus ,the combined therapy with methotrexate in rheumatoid arthritis patients

JPRN‐UMIN000008756

Abatacept‐based approach to cure of RA

JPRN‐UMIN000008812

Efficacy and safety of tocilizumab mono‐therapy in patients with large vessel vasculitis (lvv; giant cell arteritis or takayasu arteritis) and polymyalgia rheumatica (pmr)

JPRN‐UMIN000008889

Cohort study of infectious disease risk management in rheumatoid arthritis patients receiving tocilizumab

JPRN‐UMIN000009425

A validity inspection study of the treat‐to‐target strategy with golimumab for the treatment of rheumatoid arthritis patient

JPRN‐UMIN000009435

Analysis of factors for bio‐free remission due to the tight control by Remicade in rheumatoid arthritis patients. Birdie study

JPRN‐UMIN000009887

Associations between the initial concentration of serum TNF alpha and effects due to increasing a dose of infliximab, and between effects of infliximab and the concentration of serum il‐6

JPRN‐UMIN000010033

To investigate the efficacy of tocilizumab in RA patients with moderate disease activity under biologic therapy

JPRN‐UMIN000011520

Keep persistent efficacy by Abstaining from biological treatment after numerical SDAI remission with adalimumab (KANSAI study)

JPRN‐UMIN000011584

A longitudinal, prospective, multicenter observational study in patients with rheumatoid arthritis receiving tocilizumab

JPRN‐UMIN000012005

Identification of bio‐markers predicting the therapeutic effects of tocilizumab in rheumatoid arthritis

JPRN‐UMIN000012073

Effects of subcutaneous actemura and MTX blending in RA

JPRN‐UMIN000012306

Observational study for investigating the ability of recuperation of work/ house work state with tocilizumab (Actemra) subcutaneous treatment in biologics‐naive RA patients

JPRN‐UMIN000012690

Study of actemura remission induction of RA and sequential maintenance of remission by reasonable cost treatment

JPRN‐UMIN000013750

Study on effects of cytokine targeted therapy on periodontal condition in patients with rheumatoid arthritis

JPRN‐UMIN000014311

Examination of the clinical remission and functional remission in infliximab using the increase‐in‐quantity protocol to TNF‐alpha inhibitory drug resistance rheumatoid arthritis

JPRN‐UMIN000014484

Saitama Actemra study for QoL in patients with rheumatoid arthritis

JPRN‐UMIN000014670

The effect of tocilizumab on synovitis of rheumatoid arthritis. Analysis by musculoskeletal ultrasonography

JPRN‐UMIN000014934

A study for effectiveness and safety of tocilizumab therapy in rheumatoid arthritis patients with renal insufficiency.

JPRN‐UMIN000015175

Head‐to‐head comparison of subcutaneous tocilizumab versus abatacept for rheumatoid arthritis : prospective, randomized trial.

JPRN‐UMIN000015297

The feasibility study of accelerated infliximab infusion from initial administration

JPRN‐UMIN000015482

Maintenance of remission with 6‐week interval of tocilizumab in RA patients who have been in remission

JPRN‐UMIN000015616

Biologic mater clinical performance test for ADA and TCZ efficacy prediction

JPRN‐UMIN000016844

The clinical study for seeking strategy how to treat rheumatoid arthritis by TNF inhibitors

JPRN‐UMIN000016950

Clinical outcome in patients with rheumatoid arthritis switched to tumor necrosis factor blockers after tocilizumab or abatacept

JPRN‐UMIN000017230

Correlation between efficacy of the biological therapy (tocilizumab) and levels of oxidative stress markers in Japanese patients with rheumatoid arthritis (inadequate responders to existing therapies)

JPRN‐UMIN000017495

Establish the suitable strategy of maintenance therapy for rheumatoid arthritis patient with methotrexate and adalimumab

JPRN‐UMIN000017577

Tapering and withdrawal of methotrexate(MTX) or tocilizumab(TCZ), after achievement of RA remission in concomitant use of MTX and TCZ,a randomized control study.

JPRN‐UMIN000017947

Efficacy and change of serum il‐6 levels in patients with rheumatoid arthritis treated with tocilizumab

JPRN‐UMIN000018659

Inhibitory effects of tocilizumab on serum oxidative stress in patients with rheumatoid arthritis ‐comparison with other biologic agents‐

JPRN‐UMIN000020799

Efficacy of infliximab as a second bio in patients with refractory rheumatoid arthritis

JPRN‐UMIN000020833

The efficacy of iguratimod, and adding adalimumab in patients with active rheumatoid arthritis: an open label multicenter randomized parallel study

JPRN‐UMIN000021004

Effectiveness and safety of tocilizumab therapy for rheumatoid arthritis patients

JPRN‐UMIN000021048

Longitudinal study about the impact of treatment with tumor necrosis factor (TNF) inhibitors on tuberculin skin test (tst) reaction in patients with rheumatoid arthritis (RA).

JPRN‐UMIN000021247

Tocilizumab treatment with reducing and stopping methotrexate in patients with rheumatoid arthritis in stable low disease activity‐state

JPRN‐UMIN000021492

To investigate the safety of switch from infliximab biosimilar 1 in rheumatoid arthritis patients.

JPRN‐UMIN000021929

Optimization of infliximab withdrawal strategy for rheumatoid arthritis

JPRN‐UMIN000023006

Usefullness of infliximab as a second tumor necrosis factor inhibitor in patients with rheumatoid arthritis with inadequate response to tumor necrosis factor inhibitor

JPRN‐UMIN000024025

The clinical impact of methotrexate dose reduction at combination therapy with adalimumab plus methotrexate in rheumatoid arthritis; ALIBABA study

JPRN‐UMIN000024071

Serious infections after tocilizumab administration in patients with rheumatoid arthritis: a retrospective study using an adverse drug reaction database ‐analysis of clinical symptoms and laboratory test data in serious infections‐

KCT0000089

Identification of the best treatment strategy in Korean patients with early rheumatoid arthritis

NCT00000433

Blocking tumor necrosis factor in ankylosing spondylitis

NCT00001862

Tnrf:fc to treat eye inflammation in juvenile rheumatoid arthritis

NCT00001901

Etanercept to treat Wegener's granulomatosis

NCT00001954

Etanercept therapy for Sjögren's syndrome

NCT00006070

Etanercept (Enbrel) to treat pain and swelling after third molar extraction

NCT00006292

Infliximab for the treatment of early rheumatoid arthritis

NCT00012506

The safety and efficacy of a tumor necrosis factor receptor fusion protein on uveitis associated with juvenile rheumatoid arthritis

NCT00029042

Infliximab to treat children with juvenile rheumatoid arthritis

NCT00034060

The role of cytokines on growth hormone suppression in premenopausal women with rheumatoid arthritis and the effect of treatment with etanercept

NCT00036374

A study of the safety and effectiveness of infliximab (Remicade) in patients with juvenile rheumatoid arthritis

NCT00036387

A study of the safety and effectiveness of infliximab (Remicade) in patients with rheumatoid arthritis.

NCT00037648

Juvenile rheumatoid arthritis

NCT00037700

Evaluation of the efficacy of combination treatment with anakinra and pegsunercept in improving rheumatoid arthritis

NCT00048568

A phase III study of abatacept (BMS‐188667) in patients with active rheumatoid arthritis and inadequate response to methotrexate

NCT00048581

Phase III study of BMS‐188667 (CTLA4IG) in patients with rheumatoid arthritis who are currently failing anti‐TNF therapy or who have failed anti‐TNF therapy in the past.

NCT00048932

A phase III study of bms‐188667 in subjects with active rheumatoid arthritis

NCT00069329

Anakinra to treat patients with neonatal onset multisystem inflammatory disease

NCT00074438

Study to assess the efficacy and safety of rituximab in patients with rheumatoid arthritis

NCT00075075

Infliximab to treat non‐infectious scleritis

NCT00078806

Safety and efficacy study of etanercept (Enbrelâ®) in children with systemic onset juvenile rheumatoid arthritis

NCT00094341

Preference of rheumatoid arthritis (RA) patients of Enbrel® (etanercept) auto‐injector versus Enbrel® pre‐filled syringes

NCT00094900

Interleukin‐1 trap to treat autoinflammatory diseases

NCT00095147

Abatacept and infliximab in combination with methotrexate in subjects with rheumatoid arthritis

NCT00095173

BMS‐188667 in children and adolescents with juvenile rheumatoid arthritis

NCT00101829

Anti‐CD20 antibody therapy for Sjögren's syndrome

NCT00106522

A study to assess the effect of tocilizumab + methotrexate on signs and symptoms in patients with moderate to severe active rheumatoid arthritis currently on methotrexate therapy

NCT00106535

A study to assess the effect of tocilizumab + methotrexate on prevention of structural joint damage in patients with moderate to severe active rheumatoid arthritis (RA)

NCT00106548

A study to assess the effect of tocilizumab + methotrexate on signs and symptoms in patients with moderate to severe active rheumatoid arthritis

NCT00106574

A study to assess the effect of tocilizumab + DMARD therapy on signs and symptoms in patients with moderate to severe active rheumatoid arthritis

NCT00109408

A study to assess the safety and efficacy of tocilizumab in patients with active rheumatoid arthritis

NCT00111410

Evaluating the effect of anakinra (r‐methuil‐1ra) on vaccine antibody response in subjects with rheumatoid arthritis (RA)

NCT00115219

Evaluating efficacy and safety of etanercept 50 mg twice weekly (biw) in rheumatoid arthritis (RA) subjects who are sub‐optimal responders to etanercept 50 mg once weekly (qw)

NCT00121043

Evaluating Kineretâ® (anakinra) in rheumatoid arthritis (RA) subjects using aself‐reported questionnaire

NCT00122382

Remission and joint damage progression in early rheumatoid arthritis

NCT00124449

Study of abatacept versus placebo to assess the prevention of rheumatoid arthritis (RA) in adult patients

NCT00132418

Study of Enbrel in rheumatoid arthritis (RA) subjects with comorbid disorders

NCT00135720

Study of etanercept (Enbrel) in the treatment of pemphigus vulgaris

NCT00144508

Phase III comparative study(open‐label) of MRA for rheumatoid arthritis(RA)

NCT00144521

Comparative study (double‐blind) of MRA for rheumatoid arthritis (RA)

NCT00144560

Drug‐drug interaction study of MRA in patient with rheumatoid arthritis (RA)

NCT00152386

A placebo controlled study to assess efficacy and safety of certolizumab pegol in the treatment of rheumatoid arthritis

NCT00160602

A study of liquid certolizumab pegol as additional medication to methotrexate in the treatment of signs and symptoms of rheumatoid arthritis and in prevention of joint damage in patients with active rheumatoid arthritis

NCT00160641

A study of the safety and effectiveness of liquid certolizumab pegol in the treatment of signs and symptoms of rheumatoid arthritis and in prevention of joint damage in patients with active rheumatoid arthritis

NCT00160693

Open label long‐term safety study of certolizumab pegol (CZP) for patients with rheumatoid arthritis

NCT00162266

Abatacept with methotrexate‐ phase IIb

NCT00162279

The study of abatacept in combination with etanercept

NCT00175877

A study of the safety and effectiveness of lyophilized certolizumab pegol in the treatment of signs and symptoms of rheumatoid arthritis and in prevention of joint damage in patients with active rheumatoid arthritis

NCT00195494

Study comparing etanercept and methotrexate vs. Methotrexate alone in rheumatoid arthritis

NCT00195663

Efficacy and safety of adalimumab and methotrexate (MTX) versus MTX monotherapy in subjects with early rheumatoid arthritis

NCT00195702

Efficacy and safety of adalimumab in patients with active rheumatoid arthritis treated concomitantly with methotrexate

NCT00202852

A placebo‐controlled, double‐blinded, randomized trial of Remicade in Korean patients with rheumatoid arthritis despite methotrexate (study p04280)(completed)

NCT00207714

An efficacy and safety study of CNTO 148 subcutaneous injection compared with placebo in patients with active rheumatoid arthritis

NCT00216177

Comparison of adalimumab and infliximab treatment of rheumatoid arthritis

NCT00228839

Gvh 022p: study using anti tumor necrosis factor antibody (infliximab) for treatment of acute graft versus host disease

NCT00233558

Open‐label steroid reduction study of adalimumab with methotrexate in patients with active rheumatoid arthritis

NCT00234845

Adalimumab in combination with methotrexate vs methotrexate alone in early rheumatoid arthritis

NCT00234897

Efficacy of Humira in subjects with active rheumatoid arthritis

NCT00234936

Quality of life study with adalimumab in rheumatoid arthritis

NCT00235859

Adalimumab administered in Korean rheumatoid arthritis subjects treated with methotrexate

NCT00236028

A safety and efficacy study for infliximab (Remicade) with methotrexate in patients with early rheumatoid arthritis

NCT00243412

A study of the safety and efficacy of rituximab in patients with moderate to severe rheumatoid arthritis receiving methotrexate

NCT00244556

Study comparing Enbrel (etanercept) plus methotrexate versus Enbrel alone in active rheumatoid arthritis despite current methotrexate therapy

NCT00249041

Enbrel liquid immunogenicity protocol

NCT00252668

Study evaluating the combination of etanercept and methotrexate in rheumatoid arthritis subjects

NCT00254293

Study to assess steady‐state trough concentrations, safety, and immunogenicity of abatacept after subcutaneous (sc) administration to subjects with rheumatoid arthritis (RA)

NCT00259610

Treatment of early aggressive rheumatoid arthritis (TEAR)

NCT00261118

Rituximab in active ulcerative colitis

NCT00264537

A study of the safety and efficacy of golimumab in subjects with rheumatoid arthritis that are methotrexate‐naive

NCT00264550

An efficacy and safety study of golimumab in patients with active rheumatoid arthritis despite methotrexate therapy

NCT00266227

A study of retreatment with rituximab in patients with rheumatoid arthritis receiving background methotrexate

NCT00269867

Infliximab plus methotrexate for the treatment of rheumatoid arthritis

NCT00279734

Vaccination study of abatacept (BMS‐188667) for normal healthy volunteers

NCT00279760

Phase I/II multiple‐dose LEA29Y vs CTLAG4IG vs placebo in rheumatoid arthritis

NCT00282308

A study to evaluate the effects of rituximab on immune responses in subjects with active rheumatoid arthritis receiving background methotrexate

NCT00283712

Use of infliximab for the treatment of pemphigus vulgaris

NCT00291915

Multicenter randomized prospective trial comparing methotrexate alone or in combination with adalimumab in early arthritis

NCT00293202

Safety and efficacy study of the effect of etanercept in hemodialysis patients

NCT00298272

Safety and tolerability of Rituxan With methotrexate and etanercept or methotrexate and adalimumab in patients with active rheumatoid arthritis

NCT00299104

A study to evaluate rituximab in combination with methotrexate in methotrexate‐naive patients with active rheumatoid arthritis

NCT00299130

A study to evaluate the safety and efficacy of rituximab in combination with methotrexate compared to methotrexate alone in patients with active rheumatoid arthritis

NCT00299546

A study of the safety and efficacy of golimumab (CNTO 148) in subjects with active rheumatoid arthritis previously treated with biologic anti‐TNFa agent(s)

NCT00317538

Open‐label, pilot protocol of patients with rheumatoid arthritis who switch to infliximab after incomplete response to etanercept

NCT00327275

The effects of a 16‐week individualized, intensive strength training program in patients with rheumatoid arthritis

NCT00345748

A study of abatacept in Japanese patients with active rheumatoid arthritis while receiving methotrexate

NCT00361335

A study of safety and effectiveness of golimumab in participants with active rheumatoid arthritis despite methotrexate therapy

NCT00363350

Rituximab treatment in Sjögren's syndrome

NCT00365001

A drug interaction study between tocilizumab, methotrexate and simvastatin on patients with rheumatoid arthritis.

NCT00393471

Study comparing etanercept plus methotrexate to either etanercept or methotrexate alone in rheumatoid arthritis.

NCT00394589

Re³ (re‐cube: retain Remicade® response)(study P04249AM3)

NCT00396747

A comparison of methotrexate alone or combined to infliximab or to pulse methylprednisolone in early rheumatoid arthritis: a magnetic resonance imaging study

NCT00396812

Rituximab for the treatment of early rheumatoid arthritis (RA)

NCT00405275

Rheumatoid arthritis: comparison of active therapies in patients with active disease despite methotrexate therapy

NCT00409838

A phase III study of abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate

NCT00420199

A phase IIIb study of BMS‐188667 in subjects with active rheumatoid arthritis and inadequate response to methotrexate

NCT00420927

Study of the optimal protocol for methotrexate and adalimumab combination therapy in early rheumatoid arthritis

NCT00422227

Study comparing etanercept with usual DMARD therapy in subjects with rheumatoid arthritis in the Asia Pacific region

NCT00422383

A study of retreatment with Mabthera (rituximab) in combination with methotrexate in patients with rheumatoid arthritis (RA)

NCT00424502

A study of Mabthera (rituximab) in patients with rheumatoid arthritis who have had an inadequate response to a TNF‐blocker.

NCT00425932

Impact of rituximab on MRI evidence of disease activity in patients with moderate to severe rheumatoid arthritis

NCT00426543

Effect of b‐cell depletion in patients with primary Sjögren's syndrome

NCT00432406

Tumor necrosis factors (TNF)‐ blockade for psoriatic arthritis

NCT00442611

A study to evaluate the safety and efficacy of abatacept in patients with diffuse systemic sclerosis (scleroderma)

NCT00443430

Trial of early aggressive drug therapy in juvenile idiopathic arthritis

NCT00443950

Study evaluating the efficacy and safety of etanercept in Chinese subjects with rheumatoid arthritis

NCT00445770

Study evaluating the efficacy and safety of etanercept and methotrexate in Japanese subjects with rheumatoid arthritis

NCT00459706

Study comparing perceptions and satisfaction for two different delivery mechanisms for etanercept

NCT00462072

Centocor microarray study of patients

NCT00463580

A study of infliximab for treatment resistant major depression

NCT00468377

Safety and efficacy study of re‐treatment with rituximab (Mabthera/Rituxan) in patients with active rheumatoid arthritis who respond poorly to anti‐TNFî± therapies

NCT00468546

A study to evaluate the safety and efficacy of Mabthera (rituximab) in combination with methotrexate (MTX) in participants with active rheumatoid arthritis who failed on anti‐tumor necrosis factor alpha therapy

NCT00480272

Prospective study on intensive early rheumatoid arthritis treatment

NCT00484237

A study evaluating 10 mg and 25 mg doses of etanercept in patients with rheumatoid arthritis

NCT00502996

A non‐comparative study to assess the safety of Mabthera (rituximab) in patients with rheumatoid arthritis.

NCT00503425

A study of Mabthera (rituximab) in participants with rheumatoid arthritis who have had an inadequate response to disease‐modifying antirheumatic drugs (DMARD) and/or anti‐tumor necrosis factor (anti‐TNF) therapy.

NCT00514982

Medical treatment of colitis in patients with Hermansky‐Pudlak Syndrome

NCT00520572

A 6‐month randomised, double‐blind, open arm comparator, phase IIb, with azd9056, in patients with rheumatoid arthritis (RA)

NCT00521924

Induction of remission in RA patients at low disease activity by additional infliximab therapy (study P04644AM1) (terminated)

NCT00522184

Intra‐articular injection of etanercept in patient suffering from rheumatoid arthritis : a double‐blind randomized study

NCT00523692

Remission induction in very early rheumatoid arthritis

NCT00531817

A study of tocilizumab in combination with DMARDs in patients with moderate to severe rheumatoid arthritis

NCT00533897

Phase IIIb subcutaneous missed dose study

NCT00534313

Safety and efficacy of abatacept versus placebo in participants with psoriatic arthritis

NCT00535782

A study of the effect of tocilizumab on markers of atherogenic risk in patients with moderate to severe rheumatoid arthritis

NCT00537667

The spectra study

NCT00538902

Safety and efficacy study of adalimumab in adult Chinese rheumatoid arthritis subjects treated with methotrexate

NCT00544154

Efficacy and safety of CDP870 and methotrexate compared to methotrexate alone in subjects with rheumatoid arthritis

NCT00548834

Efficacy and safety of CDP870 versus placebo in the treatment of the signs and symptoms of rheumatoid arthritis

NCT00550446

A phase 2 study for patients with a physician's diagnosis of rheumatoid arthritis

NCT00555542

An analysis of peripheral blood t cell subsets on rheumatoid arthritis

NCT00559585

Methotrexate‐inadequate response study

NCT00565331

Rituximab for prevention of rejection after renal transplantation

NCT00565409

Study comparing etanercept in combination with methotrexate in subjects with rheumatoid arthritis

NCT00578305

A study of rituximab (Mabthera®/Rituxan®) in patients with rheumatoid arthritis and inadequate response to methotrexate

NCT00578565

Rituximab in rheumatoid arthritis lung disease

NCT00580229

A safety analysis of oral prednisone as a pre‐treatment for rituximab in rheumatoid arthritis.

NCT00580840

Dosing flexibility study in patients with rheumatoid arthritis

NCT00595413

Atacicept in anti‐tumor necrosis factor alpha‐naive subjects with rheumatoid arthritis (AUGUST II)

NCT00647270

Study comparing 80 mg of adalimumab with placebo, and demonstrating the non‐inferiority of monthly 80 mg adalimumab dosing compared with 40 mg adalimumab every other week dosing

NCT00647491

A study of adalimumab in adult Japanese subjects with rheumatoid arthritis

NCT00647920

Study of adalimumab administered as subcutaneous injections in adult Chinese rheumatoid arthritis subjects treated with methotrexate

NCT00649545

Study of the human anti‐TNF monoclonal antibody in patients with active rheumatoid arthritis

NCT00649922

Assessment of the effect of adalimumab on response to influenza virus and pneumococcal vaccines in subjects with rheumatoid arthritis

NCT00650026

Early access program of the safety of human anti‐TNF monoclonal antibody adalimumab in subjects with active rheumatoid arthritis

NCT00650156

Pharmacokinetic and safety study with adalimumab in Chinese subjects with mild rheumatoid arthritis

NCT00650390

Open label study to assess efficacy and safety of the fully human anti‐TNF‐alpha monoclonal antibody adalimumab

NCT00654368

CAMEO: Canadian methotrexate and etanercept outcome study

NCT00660647

Optimized treatment algorithm for patients with early rheumatoid arthritis (RA)

NCT00664521

Atacicept in combination with rituximab in subjects with rheumatoid arthritis

NCT00674362

Rheumatoid arthritis (RA) moderate to low disease activity study

NCT00678782

Evaluation of the efficacy and safety of intra‐articular etanercept in patients with refractory knee joint synovitis

NCT00683345

Fatigue and interleukin‐1 (IL‐1) blockade in primary Sjögrens syndrome

NCT00686868

Study to evaluate sc route of administration of ofatumumab in RA patients

NCT00688103

Efficacy and safety of etanercept in active RA despite methotrexate therapy in japan

NCT00689728

A study for patients with rheumatoid arthritis on methotrexate (MTX) with an inadequate response to TNF‐inhibitor therapy

NCT00691028

Efficacy and safety of increased dose of ta‐650(infliximab) in patients with rheumatoid arthritis

NCT00696059

Humira in rheumatoid arthritis ‐ do bone erosions heal?

NCT00706797

Study evaluating efficacy / safety of etanercept + methotrexate compared to usual treatment in moderate RA subjects

NCT00711503

Anti‐interleukin‐1 in diabetes action

NCT00713544

A proof of concept and dose ranging study in patients with rheumatoid arthritis

NCT00714493

RESTART C0168Z05 rheumatoid arthritis study

NCT00716248

Bucillamine study of holding remission after infliximab dose‐off

NCT00717236

Certolizumab pegol for the treatment of patients with active rheumatoid arthritis

NCT00720798

An extension study of tocilizumab (myeloma receptor antibody [MRA]) in patients completing treatment in tocilizumab core studies

NCT00721123

A long‐term extension study of tocilizumab (myeloma receptor antibody [MRA]) in patients with rheumatoid arthritis

NCT00727987

A safety and efficacy study of golimumab (CNTO 148) in patients with active rheumatoid arthritis despite methotrexate therapy

NCT00732875

A trial of anti‐TNF chimeric monoclonal antibody (CA2) in Korean patients with active rheumatoid arthritis despite methotrexate (extension part)(study P05645)(completed)

NCT00740948

Tolerance and efficacy of rituximab in Sjögren's disease

NCT00753454

Open label extension for patients coming from the dosing flexibility study in patients with rheumatoid arthritis (RA)

NCT00754559

A study to assess efficacy with respect to clinical improvement in disease activity and safety of tocilizumab in patients wtih active rheumatoid arthritis.

NCT00764725

Comparison of MTX+anti‐TNF to MTX+conventional DMARDs in patients with early rheumatoid arthritis (RA) who failed MTX alone (SWEFOT)

NCT00768053

Evaluation of eular‐raid score in rheumatoid arthritis patients

NCT00771251

A safety and efficacy study of golimumab (CNTO148) in patients with active rheumatoid arthritis (RA)

NCT00773461

A study of tocilizumab in combination with DMARD therapy in patients with active rheumatoid arthritis.

NCT00780793

Spacing of TNF‐blocker injections in rheumatoid arthritis study

NCT00783536

A multicenter study to compare the efficacy and safety of the combination of etanercept and methotrexate in treatment of rheumatoid arthritis

NCT00789724

Anakinra to prevent post‐infarction remodeling

NCT00791921

Efficacy confirmation trial of CDP870 without coadministration of methotrexate (MTX) in Japanese rheumatoid arthritis (RA)

NCT00791999

Efficacy confirmation trial of CDP870 as add‐on medication to methotrexate (MTX) in Japanese rheumatoid arthritis (RA)

NCT00794898

Efficacy of Remicade in the treatment of active rheumatoid arthritis despite methotrexate (study p03027)

NCT00796705

Switching anti‐TNF‐alpha agents in rheumatoid arthritis (RA)

NCT00808210

A study to evaluate ocrelizumab in combination with methotrexate compared with infliximab plus methotrexate in patients with active rheumatoid arthritis currently responding inadequately to etanercept or adalimumab

NCT00808509

A pilot study of the feasibility of discontinuation of adalimumab in stable rheumatoid arthritis patients in clinical remission

NCT00810199

A study of tocilizumab and methotrexate treatment strategies (adding tocilizumab to methotrexate versus switching to tocilizumab) in patients with active rheumatoid arthritis with inadequate response to prior methotrexate treatment

NCT00810277

A study of tocilizumab in patients with rheumatoid arthritis who have an inadequate response to current non‐biologic DMARDs

NCT00814866

Bone resorption, osteoclastogenesis and adalimumab

NCT00837434

Anti‐TNF agents for the treatment of rheumatoid arthritis

NCT00843778

Follow‐up of rheumatoid arthritis (RA) moderate to low disease activity study

NCT00844714

Cardiovascular risk markers in patients with rheumatoid arthritis: effect of rituximab therapy

NCT00845832

A study of combination treatment with Mabthera (rituximab) and Roactemra (tocilizumab) versus Roactemra in patients with rheumatoid arthritis with an incomplete response to methotrexate

NCT00848354

Open‐label study comparing etanercept to conventional disease modifying antirheumatic drug (DMARD) therapy

NCT00850343

Long‐term treatment study of certolizumab pegol without coadministration of methotrexate in Japanese rheumatoid arthritis (RA) patients

NCT00851318

Long‐term treatment study of certolizumab pegol (cdp870) as add‐on medication to methotrexate in Japanese rheumatoid arthritis (RA) patients

NCT00853385

A phase 3 study comparing 2 doses of CP‐690,550 and the active comparator, Humira (adalimumab) vs. Placebo for treatment of rheumatoid arthritis

NCT00858780

Study comparing the effect on disease activity when reducing or discontinuing etanercept in subjects with RA

NCT00868751

Single patient use of tocilizumab in systemic onset juvenile idiopathic arthritis

NCT00870467

A study of adalimumab in Japanese subjects with rheumatoid arthritis

NCT00887341

A study comparing infusion rates of tocilizumab in patients with moderate to severe rheumatoid arthritis

NCT00891020

A study of tocilizumab in patients with moderate to severe active rheumatoid arthritis who have an inadequate response to or are unable to tolerate biologic and non‐biologic disease‐modifying antirheumatic drugs (DMARDs)

NCT00901550

The Chinese university of Hong Kong early arthritis study

NCT00908089

Tnf‐blocking therapy in combination with disease‐modifying antirheumatic drugs in early rheumatoid arthritis

NCT00913458

Study evaluating etanercept plus methotrexate in early rheumatoid arthritis

NCT00920478

Targeting synovitis in early rheumatoid arthritis

NCT00929864

Abatacept versus adalimumab head‐to‐head

NCT00948610

Sleep and immunity in rheumatoid arthritis : Remicade substudy

NCT00963703

Treatment of TNFa naive patients with poor prognosis rheumatoid arthritis

NCT00965653

A study of subcutaneously administered tocilizumab in patients with rheumatoid arthritis

NCT00973479

An effectiveness and safety study of intravenous golimumab in patients with active rheumatoid arthritis despite treatment with methotrexate therapy

NCT00977106

Torpedo study: a study on rapid effect of tocilizumab in patients with rheumatoid arthritis with an inadequate response to disease‐modifying antirheumatic drugs (DMARDs) or anti‐TNF

NCT00979771

A study to investigate the ability of GSK706769 to maintain clinical remission after withdrawal of Enbrel in rheumatoid arthritis patients

NCT00989235

Substudy ‐ low dose of abatacept in subjects with rheumatoid arthritis

NCT00993317

A study of cdp870 as add‐on meditation to methotrexate (MTX) in patients with rheumatoid arthritis

NCT00993668

Assessing the use of certolizumab pegol in adult subjects with rheumatoid arthritis on the antibody response when receiving influenza virus and pneumococcal vaccines

NCT00996606

A study of tocilizumab in combination with disease‐modifying anti‐rheumatic drugs (DMARDs) in participants with moderate to severe active rheumatoid arthritis with an inadequate response to DMARDs

NCT01000441

Rotation or change of biotherapy after first anti‐TNF treatment failure for rheumatoid arthritis

NCT01001832

Efficacy, pharmacokinetics, safety, and immunogenicity study of abatacept administered subcutaneously to treat rheumatoid arthritis in Japanese patients

NCT01002781

Efficacy and safety of tocilizumab in adult's still disease

NCT01004432

Golimumab in rheumatoid arthritis participants with an inadequate response to etanercept (ENBREL) or adalimumab (HUMIRA)

NCT01007435

A study of tocilizumab as monotherapy and in combination with methotrexate versus methotrexate in patients with early moderate to severe rheumatoid arthritis

NCT01009879

Human tumor necrosis factor alpha (TNFa)‐induced pre‐B cell bone marrow emigrants

NCT01010503

A study of tocilizumab with or without methotrexate in patients with rheumatoid arthritis.

NCT01021735

Optimal management of rheumatoid arthritis patients requiring biologic therapy

NCT01033656

Treatment of refractory adult‐onset still's disease with anakinra: a randomized study

NCT01034137

A study of tocilizumab and methotrexate in combination or as monotherapy in treatment‐naïve patients with early rheumatoid arthritis

NCT01034397

A study of tocilizumab plus non‐biological DMARD in patients with moderate to severe rheumatoid arthritis and an inadequate response to non‐biological DMARDs

NCT01044498

A study of tocilizumab in combination with an oral contraceptive in patients with rheumatoid arthritis

NCT01072058

Heart function in rheumatoid arthritis and ankylosing spondylitis pre and post‐TNF blocker

NCT01086033

A 3‐year study following up patients with moderate to severe rheumatoid arthritis treated with Humira in Greece

NCT01088165

The influence of adalimumab on cardiovascular and metabolic risk in psoriasis

NCT01101555

Repeat dose subcutaneous Rhumatoid arthritis efficacy study

NCT01116427

A cooperative clinical study of abatacept in multiple sclerosis

NCT01117129

A study of efficacy of rituximab [Mabthera/Rituxan] in patients with rheumatoid arthritis using magnetic resonance imaging of the hand (RESONAR)

NCT01119859

A study of tocilizumab (roactemra/Actemra) versus adalimumab in patients with rheumatoid arthritis

NCT01120366

Success of tocilizumab in RA patients with remission induction and sustained efficacy after discontinuation

NCT01123070

Tl011 in severe, active rheumatoid arthritis patients

NCT01126541

SMART Study: a study of re‐treatment with Mabthera (rituximab) in patients with rheumatoid arthritis who have failed on anti‐TNF alfa therapy

NCT01142726

Efficacy and safety study of abatacept subcutaneous plus methotrexate in inducing remission in adults with very early rheumatoid arthritis

NCT01147341

Can TNF‐alpha incomplete secondary responders attain a safe and efficacious response switching to Cimzia

NCT01162421

A Canadian study to evaluate early use of adalimumab after methotrexate failure in early rheumatoid arthritis

NCT01163617

The usability and injection time of the Physiolis syringe and autoinjector in rheumatoid arthritis patients

NCT01163747

A study of the effects of Roactemra/Actemra on vaccination in patients with rheumatoid arthritis on background methotrexate (VISARA)

NCT01173120

Methotrexate ‐ inadequate response device sub‐study

NCT01185288

A study to determine the effect of methotrexate (MTX) dose on clinical outcome and ultrasonographic signs in subjects with moderately to severely active rheumatoid arthritis (RA) treated with adalimumab (MUSICA)

NCT01185301

Study to determine the effects of different doses of methotrexate (MTX) when taken with adalimumab in subjects with early rheumatoid arthritis (RA)

NCT01185522

An observational study of the impact of Roactemra/Actemra on fatigue in patients with rheumatoid arthritis (PEPS)

NCT01194414

A study to compare subcutaneous versus intravenous administration of Roactemra/Actemra (tocilizumab) in participants with moderate to severe active rheumatoid arthritis

NCT01197066

Open‐label, extension study of CDP870 in patients with rheumatoid arthritis

NCT01197144

Pain modulation in rheumatoid arthritis (RA) ‐ influence of adalimumab

NCT01211834

Efficacy and safety of tocilizumab in combination with DMARDs in patients with moderate to severe rheumatoid arthritis

NCT01212094

Double blind combination of rituximab by intravenous and intrathecal injection versus placebo in patients with low‐inflammatory secondary progressive multiple sclerosis (RIVITALISE)

NCT01213017

The effect of certolizumab pegol on MRI synovitis and bone edema in rheumatoid arthritis patients

NCT01216631

Seronegative oligoarthritis of the knee study (SOKS)

NCT01217086

Program evaluating the autoimmune disease investigational drug ct‐p13 in RA patients(PLANETRA)

NCT01217814

Effect of sar153191 (regn88) with methotrexate in patients with active rheumatoid arthritis who failed TNF‐î± blockers

NCT01221636

Pharmacokinetic study to compare the blood levels of low vs high metal manufacture of abatacept

NCT01225393

A study to evaluate the efficacy and safety of MLTA3698A in combination with a disease‐modifying anti‐rheumatic drug (DMARD) compared with adalimumab in combination with a DMARD in patients with active rheumatoid arthritis

NCT01232569

A study of Roactemra/Actemra (tocilizumab) given subcutaneously in combination with traditional DMARDs in patients with moderate to severe active rheumatoid arthritis

NCT01235598

Magnetic resonance image verified early response to certolizumab pegol in subjects with active rheumatoid arthritis (RA)

NCT01242488

Efficacy and safety of CDP6038 in patients with rheumatoid arthritis with an unsuccessful response to anti‐tumor necrosis factor (anti‐TNF) therapy

NCT01244958

Addition of rituximab to leflunomide in patients with active rheumatoid arthritis

NCT01245361

A 6‐months infliximab or placebo study in UA at high risk of RA:clinical,radiological and synovial benefit

NCT01245439

A study of Roactemra/Actemra (tocilizumab) in patients with moderate to severe rheumatoid arthritis

NCT01245452

Study of the response and cardiorespiratory endurance in early RA patients treated with tocilizumab or methotrexate

NCT01248780

Study of subcutaneous golimumab in Chinese patients with active rheumatoid arthritis despite methotrexate therapy

NCT01251120

A study of Roactemra/Actemra (tocilizumab) in combination with DMARDs versus current best practice DMARD therapy in patients with rheumatoid arthritis

NCT01255761

A comparison of two assessment tools in predicting treatment success of Cimzia in rheumatoid arthritis subjects

NCT01258712

Study of tocilizumab in combination with methotrexate for treatment of moderate to severe rheumatoid arthritis patients

NCT01264770

Evaluation of efficacy and safety of Fostamatinib monotherapy compared with adalimumab monotherapy in patients with rheumatoid arthritis (RA)

NCT01270035

Efficacy and safety of adalimumab 80 mg every other week with methotrexate

NCT01270087

The effect of adalimumab (Humira) on vascular abnormalities in rheumatoid arthritis. A pilot study

NCT01270997

Randomized double‐blind parallel trial to evaluate equivalence in efficacy and safety of hd203 and Enbrel in RA patients

NCT01272908

A study of Mabthera (rituximab) in patients with rheumatoid arthritis who have failed on one prior anti‐TNF therapy (reset)

NCT01274182

Gp2013 in the treatment of RA patients refractory to or intolerant of standard therapy

NCT01283971

A study of Roactemra/Actemra (tocilizumab) versus adalimumab in combination with methotrexate (MTX) in patients with moderate to severe active rheumatoid arthritis and an inadequate response to treatment with only one tumor necrosis factor (TNF)‐inhibitor

NCT01292265

A 12 week study to assess changes in joint inflammation using ultrasonography in patients with rheumatoid arthritis (RA)

NCT01295151

SWITCH clinical trial for patients with rheumatoid arthritis who have failed an initial TNF‐blocking drug

NCT01295814

Efficacy study of adalimumab to treat interstitial cystitis

NCT01303874

Etanercept and methotrexate in patients to induce remission in early arthritis (empire)

NCT01308255

Infliximab as induction therapy in early rheumatoid arthritis (idea)

NCT01313208

Moderate rheumatoid arthritis (RA) with etanercept (Enbrel)

NCT01313520

A study to evaluate the effectiveness of infliximab and changes in hand and wrist magnetic resonance imaging (MRI) in participants with active rheumatoid arthritis (RA) (p08136)

NCT01326962

A study of Roactemra/Actemra (tocilizumab) in patients with rheumatoid arthritis who have an inadequate response to DMARDs or anti‐TNF

NCT01331837

A study of tocilizumab in comparison to etanercept in participants with rheumatoid arthritis and cardiovascular disease risk factors

NCT01333878

Impact of subcutaneous abatacept in rheumatoid arthritis assessing inhibition of structural damage

NCT01338103

Treatment of pemphigus patients with rituximab 1000mgx2 and assessment of immune status via Cylex

NCT01350804

Efficacy at 24 weeks and safety, tolerability and long term efficacy of secukinumab (ain457) in patients with active rheumatoid arthritis (RA) and an inadequate response to anti‐tumor necrosis factor α (Anti‐TNFα) agents (CAIN457f2309 and CAIN457f2309e1)

NCT01351480

Benefits of injectable abatacept using magnetic resonance imaging (MRI) in rheumatoid arthritis (RA) patients

NCT01362153

A pharmacokinetic (pk) and pharmacodynamic (pd) study of golimumab in patients with rheumatoid arthritis (RA)

NCT01369017

Effect of interleukin‐1 receptor antagonist on inhalation of 20,000 EU clinical CTR reference endotoxin in normal volunteers

NCT01373151

Phase IIB rheumatoid arthritis dose ranging study for BMS‐945429 in subjects who are not responding to methotrexate

NCT01374971

Rheumatoid arthritis treatment and biopsy study assessing certolizumab pegol (Cimzia)

NCT01382160

Serum concentration of adalimumab as a predictive factor of clinical outcomes in rheumatoid arthritis (AFORA)

NCT01390441

A study of the pharmacokinetics and safety of mk‐8808 (MK‐8808‐002)

NCT01390545

Velvet, a dose range finding trial of veltuzumab in subjects with moderate to severe rheumatoid arthritis

NCT01394913

Comparison of two etanercept regimens (Reumatocept® versus Enbrel®) for treatment of rheumatoid arthritis

NCT01396317

Study of tocilizumab to treat polymyalgia rheumatica

NCT01399697

A study of Roactemra/Actemra (tocilizumab) in combination with methotrexate versus Roactemra/Actemra monotherapy in patients with rheumatoid arthritis and an inadequate response to methotrexate

NCT01405326

Restore Working Ability in rheumatoid arthritis

NCT01426815

Exploration of TNF‐alpha blockade with golimumab in the induction of clinical remission in patients with early peripheral spondyloarthritis (SPA) according to ASAS‐criteria

NCT01439204

Pharmacokinetic study to compare the blood levels of abatacept manufactured at Lonza biologics to the blood levels of abatacept manufactured at the Devens, Massachusetts (MA) facility of Bristol‐Myers Squibb

NCT01443364

Open label study to assess the predictability of early response to certolizumab pegol in patients with rheumatoid arthritis

NCT01451203

Efficacy confirmation study of cdp870 in early rheumatoid arthritis

NCT01468077

A study in patients with moderate to severe active rheumatoid arthritis comparing different infusion durations of Roactemra/Actemra (tocilizumab) treatment

NCT01491815

Active conventional therapy compared to three different biologic treatments in early rheumatoid arthritis with subsequent dose reduction

NCT01500278

Study to assess the short‐ and long‐term efficacy of certolizumab pegol plus methotrexate compared to adalimumab plus methotrexate in subjects with moderate to severe rheumatoid arthritis (RA) inadequately responding to methotrexate

NCT01502423

A crossover study of the safety and tolerability of two formulations of adalimumab

NCT01519791

A multi‐center, randomized, double‐blind, placebo‐controlled study to evaluate the efficacy and safety of certolizumab pegol in combination with methotrexate in the treatment of disease modifying antirheumatic drugs (DMARD)‐naïve adults with early active rheumatoid arthritis

NCT01521923

A multi‐center, randomized, double‐blind, placebo‐controlled study to evaluate the efficacy and safety of certolizumab pegol in combination with methotrexate in the treatment of disease modifying antirheumatic drugs (DMARD)‐naïve adults with early active rheumatoid arthritis

NCT01526057

A pharmacokinetic/pharmacodynamic study comparing pf‐05280586 to rituximab in subjects with active rheumatoid arthritis with an inadequate response to TNF inhibitors (reflections b328‐01)

NCT01534884

Demonstrate the equivalence of ct‐p10 to Mabthera with respect to the pharmacokinetic profile in patients with rheumatoid arthritis

NCT01548768

RHYTHM (formerly Escape II Myocardium)

NCT01557374

Toward the lowest effective dose of abatacept or tocilizumab

NCT01561313

Crossover study of safety and tolerability of two formulations of adalimumab

NCT01566201

Effects of interleukin‐1 inhibition on vascular and left ventricular function in rheumatoid arthritis patients with coronary artery disease

NCT01567358

Study of ni‐071 in comparison with Remicade in patients with rheumatoid arthritis

NCT01571219

An extension study to demonstrate long‐term efficacy and safety of CT‐P13 when co‐administered with methotrexate in patient with rheumatoid arthritis who were treated with infliximab (Remicade or CT‐P13) in study CT‐P13 3.1

NCT01578850

Study conducted in subjects with rheumatoid arthritis who have moderate to severe disease activity despite methotrexate therapy with or without other non biologic disease modifying antirheumatic drugs (DMARDs)for at least 12 weeks prior to screening

NCT01587989

A study of Roactemra/Actemra (tocilizumab) with or without methotrexate in patients with mild to moderate rheumatoid arthritis with an inadequate response to methotrexate

NCT01590966

Scintigraphic detection of the biodistribution of tumor necrosis factor with a radiolabeled anti‐TNFî± in patients with active rheumatoid arthritis and active axial and peripheral spondyloarthritis

NCT01602302

Ultrasound and withdrawal of biological DMARDs in rheumatoid arthritis

NCT01609205

Doppler evaluation in RA patients after adalimumab

NCT01635686

Comparison the safety and pharmacokinetic characteristics of DWP422 25 mg with those of Enbrel 25MG PFS inj. after subcutaneous injection in healthy male volunteers

NCT01638715

A randomized, multi‐center biomarker trial to predict therapeutic responses of patients with rheumatoid arthritis to a specific biologic mode of action

NCT01643928

Rheumatoid arthritis extension trial for subjects who have participated in other PF‐05280586 trials (reflections b328‐04)

NCT01649804

A long‐term safety extension study of WA19926 in participants with rheumatoid arthritis

NCT01657513

TNF‐alfa inhibitors and antibody production in patients with psoriasis

NCT01661140

A study of Roactemra/Actemra (tocilizumab) in combination with methotrexate in patients with severe active rheumatoid arthritis, comparing tapering versus maintaining the methotrexate dosage

NCT01664598

An extension study of wa19926 of the long‐term safety of Roactemra/Actemra (tocilizumab) in patients with early moderate to severe rheumatoid arthritis

NCT01665430

A long‐term extension study to wa19926 of Roactemra/Actemra (tocilizumab) in patients with early, moderate to severe rheumatoid arthritis

NCT01668966

A long term extension study of wa19926 (nct01649804) of tocilizumab (Roactemra/Actemra) in participants with early moderate to severe rheumatoid arthritis

NCT01682512

Efficacy, pharmacokinetics, and safety of bi 695500 in patients with rheumatoid arthritis

NCT01690299

Phase 3b safety and efficacy study of apremilast to treat moderate to severe plaque‐plaque psoriasis

NCT01696929

An open‐label trial of tocilizumab in schizophrenia

NCT01710358

A study in moderate to severe rheumatoid arthritis

NCT01712178

A study in rheumatoid arthritis (RA) patients to compare two formulations of adalimumab for pharmacokinetic, pharmacodynamic and safety

NCT01715831

A long‐term safety extension study of tocilizumab in Brazilian participants with RA having completed the studies ml21530 and ma21488

NCT01715896

A study of mavrilimumab versus anti tumor necrosis factor in subjects with rheumatoid arthritis

NCT01717859

Musculoskeletal ultrasound in predicting early dose titration with tocilizumab

NCT01724268

Corticosteroids and anti TNF in methotrexate inadequate responder rheumatoid arthritis patient

NCT01730456

A long‐term extension study of Roactemra/Actemra (tocilizumab) in patients with early moderate to severe rheumatoid arthritis who completed study WA19926

NCT01734993

A long‐term extension study of WA22762 to evaluate safety and efficacy of subcutaneous tocilizumab in participants with moderate to severe rheumatoid arthritis (RA).

NCT01752335

Effect of monoclonal anti‐il6 antibody (tocilizumab) on the cardiovascular risk in patients with rheumatoid arthritis

NCT01752855

Study in rheumatoid arthritis for subjects who completed preceding study M13‐390 with adalimumab

NCT01758198

Abatacept post‐marketing clinical study in Japan

NCT01759030

Study of safety and efficacy of BCD‐020 comparing to Mabthera in patients with rheumatoid arthritis

NCT01764997

An evaluation of sarilumab plus methotrexate compared to etanercept plus methotrexate in RA patients not responding to adalimumab plus methotrexate

NCT01765374

Study of sonographic efficacy of rituximab in rheumatoid arthritis

NCT01768572

To evaluate the safety of SAR153191 (REGN88) and tocilizumab added to other RA drugs in patients with RA who are not responding to or intolerant of anti‐TNF therapy (SARIL‐RA‐ASCERTAIN)

NCT01772316

A long‐term extension study of wa22763 and na25220 of subcutaneous Roactemra/Actemra (tocilizumab) in patients with moderate to severe rheumatoid arthritis

NCT01782235

Efficacy of tocilizumab in primary Sjögren's syndrome.

NCT01783015

Study of etanercept in subjects with rheumatoid arthritis who have had an inadequate response to adalimumab or infliximab plus methotrexate

NCT01793519

Stopping TNF alpha inhibitors in rheumatoid arthritis

NCT01794117

Anakinra for inflammatory pustular skin diseases

NCT01835613

Evaluation effects of treatment with il‐6r inhibitor on clinical response and biomarkers in patients with rheumatoid arthritis (RA) not responding to DMARDs and/or a first biological agent.

NCT01842386

Rituximab for anti‐cytokine autoantibody‐associated diseases

NCT01844895

Methotrexate‐inadequate response autoinjector device sub study

NCT01846975

Introducing a single iv abatacept treatment in RA patients currently receiving weekly sc abatacept to simulate a holiday

NCT01855789

A study of the impact of methotrexate (MTX) discontinuation on the efficacy of subcutaneous tocilizumab with methotrexate in participants with moderate to severe active rheumatoid arthritis

NCT01864265

Prediction of response to certolizumab pegol treatment by functional MRI of the brain

NCT01873443

Long‐term efficacy and safety of ct‐p10 in patients with RA

NCT01875991

Preference between two autoinjectors in patients with rheumatoid arthritis and plaque psoriasis treated with etanercept

NCT01878318

A study of the effect of Roactemra/Actemra (tocilizumab) in combination with methotrexate on articular damage in the hand in patients with moderate to severe rheumatoid arthritis who have an inadequate response to non‐biological DMARDs

NCT01890473

Study to characterize the pharmacokinetics of a single dose of sc abatacept 125 mg using the bd autoinjector or the prefilled syringe

NCT01893996

Study of adalimumab to lower cardiovascular risk in RA patients with well controlled joint disease

NCT01895309

A study comparing sb4 to Enbrelâ® in subjects with moderate to severe rheumatoid arthritis despite methotrexate therapy

NCT01901185

Study to evaluate the ability of subjects with rheumatoid arthritis or psoriatic arthritis to effectively use a reusable autoinjector to self‐inject etanercept

NCT01927263

A phase 3 study of ni‐071 in patients with rheumatoid arthritis

NCT01927757

Evaluating etanercept use in patients with moderate to severe rheumatoid arthritis who have lost response to adalimumab

NCT01936181

A study comparing SB2 to Remicade® in subjects with moderate to severe rheumatoid arthritis despite methotrexate therapy

NCT01941095

A study of subcutaneously administered Roactemra/Actemra (tocilizumab) in patients with rheumatoid arthritis

NCT01941940

A study to evaluate efficacy of tocilizumab administered as monotherapy or in combination with methotrexate and/or other disease modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) participants

NCT01951170

An open‐label study of Roactemra/Actemra (tocilizumab) in patients with moderate to severe active rheumatoid arthritis

NCT01954979

A phase i study of abatacept in the treatment of patients with steroid refractory chronic graft versus host disease (CGVHD)

NCT01962974

A golimumab phase 3b, multicenter, assessment of intravenous efficacy in rheumatoid arthritis subjects who have diminished disease control despite treatment with infliximab (Remicadeâ®)

NCT01969409

Autoantibody reduction therapy in patients with idiopathic pulmonary fibrosis

NCT01970475

Efficacy and safety study of ABP 501 compared to adalimumab in subjects with moderate to severe rheumatoid arthritis

NCT01987479

The safety and efficacy of Roactemra/Actemra alone or in combination with non‐biologic antirheumatics in rheumatoid arthritis patients.

NCT01999868

Efficacy of ustekinumab followed by abatacept for the treatment of psoriasis vulgaris

NCT02001987

A study of Roactemra/Actemra (tocilizumab) in tocilizumab‐naive patients with rheumatoid arthritis with inadequate response to non‐biologic disease‐modifying antirheumatic drugs (DMARDs) or biologic therapy

NCT02010216

A study of Roactemra/Actemra (tocilizumab) in adult patients with rheumatoid arthritis (SVOBODA Programme)

NCT02018042

An open‐label single‐arm clinical trial to evaluate the efficacy of abatacept in moderate to severe patch type alopecia areata

NCT02019472

A study comparing sirukumab (CNTO 136) monotherapy with adalimumab (Humira®) monotherapy in the treatment of active rheumatoid arthritis

NCT02019602

A multicener, postmarketing study evaluating the transfer of Cimzia from the mother to the infant via the placenta

NCT02027298

Abatacept for patients with inflammatory arthritis associated with Sjögren's syndrome: an open‐label phase II study

NCT02035800

Bone resorption, osteoclastogenesis and adalimumab

NCT02053727

Abatacept vs placebo in RA patients with hepatitis B on entecavir background

NCT02056184

Targeted ultrasound in rheumatoid arthritis

NCT02067910

Efficacy and safety of abatacept in patients with primary Sjögren's syndrome

NCT02079532

A study of Mabthera (rituximab) in patients with rheumatoid arthritis who have had an inadequate response to a single anti‐TNF inhibitor

NCT02090101

Study evaluating the influence of lv5fu2 bevacizumab plus anakinra association on metastatic colorectal cancer

NCT02092467

Safety study of tofacitinib versus tumor necrosis factor (TNF) inhibitor in subjects with rheumatoid arthritis

NCT02092961

Randomised double‐blind, placebo‐controlled, parallel group study in patients with active rheumatoid arthritis: magnetic resonance imaging sub‐study

NCT02097264

A trial investigating the mechanism of action of NNC0109‐0012 (anti‐IL‐20 MAB) through synovial biopsies in subjects with rheumatoid arthritis and an inadequate response to methotrexate

NCT02097524

Single‐dose study to describe the pharmacodynamics (pd) and safety of sarilumab (regn88/sar153191) and tocilizumab in adults with rheumatoid arthritis (RA)

NCT02097745

A study of the efficacy and safety of re‐treatments with rituximab in patients with active rheumatoid arthritis who have had an inadequate response to anti‐TNFa therapies

NCT02109289

Etanercept in rheumatoid arthritis and vascular inflammation

NCT02114931

Long‐term safety and efficacy of ABP 501 in subjects with moderate to severe rheumatoid arthritis

NCT02115750

Comparison of CHS‐0214 to Enbrel (etanercept) in patients with rheumatoid arthritis (RA)

NCT02116504

Anti‐biopharmaceutical immunization: prediction and analysis of clinical relevance to minimize the risk of immunization in rheumatoid arthritis patients or juvenile idiopathic arthritis patients

NCT02132234

Effects of biological treatment on blood pressure and endothelial function in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

NCT02137226

BI 695501 compared to adalimumab in patients with active rheumatoid arthritis

NCT02141997

A study to investigate the safety and efficacy of ABT‐122 given with methotrexate in subjects with active rheumatoid arthritis who have an inadequate response to methotrexate

NCT02148640

The NOR‐SWITCH study

NCT02148718

Rapidity of response to adalimumab treatment in patients with Crohn's disease

NCT02149121

Pk similarity prospective phase 3 study in patients with rheumatoid arthritis

NCT02150473

The effect of adalimumab plus methotrexate (MTX) versus placebo plus MTX on cartilage in (RA) patients

NCT02151851

A study of certolizumab pegol as additional therapy in Chinese patients with active rheumatoid arthritis

NCT02154425

A multicenter, postmarketing study evaluating the concentration of Cimzia® in mature breast milk of lactating mothers

NCT02167139

A study comparing SB5 to Humira® in subjects with moderate to severe rheumatoid arthritis despite methotrexate therapy

NCT02175056

A dose‐block randomized, placebo controlled (double‐blind), active controlled(open‐label), dose‐escalation study

NCT02187055

An efficacy and safety study evaluating tofacitinib with and without methotrexate compared to adalimumab with methotrexate

NCT02198651

A phase 4 trial assessing the impact of Residual Inflammation Detected Via Imaging techniques, Drug Levels and Patient Characteristics on the Outcome of Dose tapering of Adalimumab in Clinical Remission Rheumatoid arthritis (RA) subjects (PREDICTRA)

NCT02222493

A study of pf‐06438179 (infliximab‐Pfizer) and infliximab in combination with methotrexate in subjects with active rheumatoid arthritis (reflections B537‐02).

NCT02232880

Treatment of resistant hypertension by prevention of t‐cell co‐stimulation

NCT02236481

Clinical study to evaluate the efficacy of anakinra in patients with rheumatoid arthritis and diabetes

NCT02242474

Anti‐TNF use during elective foot and ankle surgery in patients with rheumatoid arthritis

NCT02260791

A study to compare FKB327 efficacy and safety with Humira® in rheumatoid arthritis patients

NCT02287922

A phase IIb study for alx‐0061 monotherapy in subjects with rheumatoid arthritis

NCT02293590

Rice: remission by intra‐articular injection plus certolizumab

NCT02296775

Comparative pharmacokinetic, pharmacodynamic, safety and efficacy study of three anti‐cd20 monoclonal antibodies in patients with moderate to severe rheumatoid arthritis

NCT02304354

Relationship between t lymphocytes depletion and clinical response to rituximab in rheumatoid arthritis (Lyritux)

NCT02308163

A study to evaluate safety and efficacy of asp015k in patients with rheumatoid arthritis (RA) who had an inadequate response to DMARDs

NCT02319642

An open‐label extension study of certolizumab pegol in Chinese patients with rheumatoid arthritis who enrolled in RA0044

NCT02332590

Efficacy and safety of sarilumab and adalimumab monotherapy in patients with rheumatoid arthritis (SARIL‐RA‐MONARCH)

NCT02353780

Mechanistic studies of b‐ and t‐cell function in RA patients treated with TNF antagonists, tocilizumab, or abatacept

NCT02357069

A study comparing lbec0101 to Enbrelâ® in subjects with active rheumatoid arthritis despite methotrexate therapy

NCT02371096

Comparative pharmacokinetic trial of rgb‐03 and Mabthera

NCT02373813

Study of etanercept monotherapy vs methotrexate monotherapy for maintenance of rheumatoid arthritis remission

NCT02374021

Treatments against RA and effect on FDG‐PET/CT

NCT02376335

B‐cell depleting therapy (rituximab) as a treatment for fatigue in primary biliary cirrhosis

NCT02378506

Study to assess the immunogenicity, safety, and efficacy of high capacity process etanercept in rheumatoid arthritis subjects

NCT02393378

Namilumab vs adalimumab in participants with moderate to severe early rheumatoid arthritis inadequately responding to methotrexate

NCT02404558

Single‐dose study to describe the safety of sarilumab and tocilizumab in patients with rheumatoid arthritis

NCT02405780

A study to compare FKB327 long‐term safety, efficacy and immunogenicity with Humira® in rheumatoid arthritis patients

NCT02429934

Abatacept for SLE arthritis (im101‐330)

NCT02430909

Multiple dose study of ucb4940 as add‐on to certolizumab pegol in subjects with rheumatoid arthritis

NCT02433184

Very early versus delayed etanercept in patients with RA

NCT02451839

An observational study of the effectiveness of adalimumab on health and disability outcomes in New Zealand patients with immune‐mediated inflammatory diseases (VITALITY)

NCT02466581

Dose reduction for early rheumatoid arthritis patients with low disease activity

NCT02468791

MabionCD20® compared to Mabthera® in patients with rheumatoid arthritis

NCT02480153

A study of PF‐06410293 (adalimumab‐Pfizer) and adalimumab (Humira) In combination with methotrexate in subjects with active rheumatoid arthritis (REFLECTIONS B538‐02)

NCT02481180

Tolerance, pharmacokinetics and preliminary efficacy of t0001 in RA (rheumatoid arthritis)

NCT02495129

Study of pharmacodynamic effects of vay736 in patients with primary Sjögren's syndrome

NCT02504268

Effects of abatacept in patients with early rheumatoid arthritis

NCT02514772

Gp2013 treatment in patients with active rheumatoid arthritis, previously treated with Rituxan® or Mabthera®

NCT02526992

Evaluation by HR‐pqct of bone microarchitecture changes in patients with rheumatoid arthritis under anti‐TNF therapy

NCT02547493

Vaccination against pneumococcal in naïve abatacept rheumatoid arthritis patients

NCT02557100

Study to assess changes in the immune profile in adults with early rheumatoid arthritis

NCT02565810

An multicentre clinical study to evaluate the usability and safety of the pre‐filled pen and pre‐filled syringe of SB5 in subjects with rheumatoid arthritis

NCT02573012

Study to compare the efficacy of tocilizumab with or without glucocorticoid discontinuation in rheumatoid arthritis participants

NCT02616380

Real‐world outcome of adalimumab on rheumatoid arthritis patients in Taiwan

NCT02629159

A study comparing ABT‐494 to placebo and to adalimumab in subjects with rheumatoid arthritis who are on a stable dose of methotrexate and who have an inadequate response to methotrexate

NCT02631538

Safety and efficacy study of subcutaneous belimumab and intravenous rituximab co‐administration in subjects with primary Sjögren's syndrome

NCT02638259

Comparative efficacy and safety study of gp2015 and Enbrel® in patients with rheumatoid arthritis

NCT02640612

Long‐term assessment of safety and efficacy of BI 695501 in patients with rheumatoid arthritis

NCT02652273

Inhibition of co‐stimulation in rheumatoid arthritis

NCT02659150

Effect of subcutaneous Actemra on inflamed atherosclerotic plaques in patients with rheumatoid arthritis

NCT02682823

Tocilizumab real‐life human factors (RLHFS) validation study

NCT02683564

Bow015 (infliximab‐epirus) and infliximab in patients with active rheumatoid arthritis: the uniform study

NCT02693210

A study to evaluate the efficacy and safety of Mabthera alone and in combination with either cyclophosphamide or methotrexate in patients with rheumatoid arthritis

NCT02714634

Clinical trial evaluating methotrexate + biologic versus methotrexate, salazopyrine and hydroxychloroquine in patients with rheumatoid arthritis and insufficient response to methotrexate

NCT02714881

Lipids, inflammation, and CV risk in RA

NCT02715908

A study to evaluate the long‐term safety and efficacy of lbec0101 in subjects with active rheumatoid arthritis despite methotrexate (MTX)

NCT02722044

Usability of an AI for M923 in subjects with moderate to severe RA

NCT02722694

A phase 3 study of abatacept in chinese patients with active rheumatoid arthritis and inadequate response to methotrexate

NCT02731560

Rituximab (rtx) for disease modifying anti rheumatic drug (DMARD) non‐responders in Pakistan: the Pakistan rituximab study (PaRiS)

NCT02743390

Effects of the TNF‐alpha inhibitIon on hemodynamic parameters in resistant hypertension

NCT02744196

Clinical trial to evaluate efficacy and safety of Acellbia® (JSC "Biocad") with methotrexate in first line biological therapy of patients with active rheumatoid arthritis

NCT02744755

Clinical trial to compare treatment with GP2017 and Humira® in patients with rheumatoid arthritis

NCT02746380

A study comparing LBAL to Humira® in subjects with active rheumatoid arthritis despite methotrexate therapy

NCT02760407

Evaluation of the effectiveness and safety of two dosing regimens of Olokizumab (OKZ), compared to placebo and adalimumab, in subjects with rheumatoid arthritis (RA) who are taking methotrexate but have active disease

NCT02762838

Comparative clinical trial of efficacy and safety of BCD‐055 and Remicade® in combination with methotrexate in patients with active rheumatoid arthritis

NCT02765074

Filling bone erosions: a longitudinal multicentric HR‐PQCT study of subcutaneous tocilizumab in rheumatoid arthritis

NCT02770794

Optimization of infliximab withdrawal strategy for rheumatoid arthritis

NCT02778906

Abatacept reversing subclinical inflammation as measured by MRI in ACPA positive arthralgia

NCT02779114

Retro (reduction of therapy in RA patients in ongoing remission)

NCT02780583

Treatment of macrophage activation syndrome (mas) with anakinra

NCT02792699

Study to assess if ABP798 is safe & effective in treating moderate to severe rheumatoid arthritis compared to rituximab

NCT02805010

Pharmacokinetics, safety and tolerability study of single dose of abatacept 125mg administered subcutaneously

NCT02819726

A study to compare the pharmacokinetics, pharmacodynamics, safety, and efficacy of sait101 versus Mabthera® versus Rituxan® in patients with rheumatoid arthritis (RA)

NCT02833350

Safety and efficacy study of GDC‐0853 compared with placebo and adalimumab in participants with rheumatoid arthritis (RA)

NCT02837146

Ultrasound as imaging biomarker of early response to tocilizumab and methotrexate in very early rheumatoid arthritis

NCT02840175

Treatment tapering in JIA with inactive disease

NCT02843789

Evolution of adipokines and body composition in rheumatoid arthritis patients receiving tocilizumab therapy

NCT02862574

GS‐5745 as add‐on therapy to a tumor necrosis factor inhibitor and methotrexate regimen in adults with moderately to severely active rheumatoid arthritis

NCT02889796

Filgotinib in combination with methotrexate in adults with moderately to severely active rheumatoid arthritis who have an inadequate response to methotrexate

NCT02908217

Safety and efficacy of tocilizumab versus placebo in polymyalgia rheumatica with glucocorticoid dependence semaphore

NCT02915159

A study to assess the efficacy and safety of abatacept in adults with active primary Sjögren's syndrome

NCT02935387

Remission induction in very early rheumatoid arthritis

NCT02937701

Study to assess if abp710 is safe & effective in treating moderate to severe rheumatoid arthritis compared to infliximab

NCT02986139

Assess the injection site pain associated with a new etanercept formulation in adult subjects with RA or PSA

NCT02990806

A phase 3 study of ni‐071 in patients with rheumatoid arthritis (RADIANCE)

NTR1011

Hypothesis generating study to identify the changes in synovial tissue early after initiation of infliximab therapy

NTR1088

Sevra‐trial safety and efficacy of vaccination with t cell‐dependent and t cell‐independent primary and recall antigens in patients with rheumatoid arthritis treated with anti TNF‐á antibodies (adalimumab) and anti B cell therapy (rituximab).

NTR1137

An open‐label pilot study on the effects of trivalent inactivated influenza vaccination (Influvac®) in rheumatoid arthritis patients treated with rituximab.

NTR1210

Exploratory trial on intra‐articular etanercept treatment in inflammatory arthritis

NTR144

Strategies in early arthritis management.

NTR1605

(English) Cost‐effectiveness of new medicines (Mabthera and Orencia) compared to a second TNF blocking medicine, for patients with inadequate effect of a first TNF blocking medicine. (Dutch) Onderzoek naar de kosteneffectiviteit van nieuwe medicijnen (Mabthera en Orencia) vergeleken met een tweede TNF blokerend middel, voor patienten met onvoldoende effect van een eerste behandeling met TNF blokkerende middelen.

NTR2911

Tocilizumab met biopten cohort. Tocilizumab with biopsy cohort.

NTR3216

Onderzoek naar non inferioriteit van afbouw en stop behandelstrategieën van adalimumab of etanercept bij patiënten met reumatoïde artritis: kosten besparen tegen welke prijs?

NTR3327

Influence of rituximab on endothelial dysfunction in RA.

NTR3509

Therapeutic drug monitoring: toward tailored dosing of adalimumab in rheumatoid arthritis

NTR383

The efficacy and safety of intra‐articular injections with the TNF‐a antagonist infliximab in patients with chronic or recurrent arthritis of the knee.

NTR3903

Dose‐to‐target of etanercept treatment in rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis.

NTR5279

The effect of switching treatment from innovator infliximab to infliximab biosimilar on efficacy, safety and immunogenicity in patients with rheumatoid arthritis, spondyloarthritis or psoriatic arthritis in daily clinical care

NTR801

IMPROVED: Induction therapy with methotrexate and prednisone in rheumatoid or very early arthritic disease

NTR851

Prospective study on the effects of rituximab on synovial tissue of patients with rheumatoid arthritis.

NTR859

Identification of predictive factors in synovial samples for the clinical response to TNF‐alpha blockade in rheumatoid arthritis.

SLCTR/2008/008

Efficacy of low dose rituximab with methotrexate compared to leflunomide with methotrexate in patients with refractory rheumatoid arthritis: a randomized double blind controlled clinical trial

Appendix 3. Summary of safety warnings from regulatory agencies

Abatacept

No recent warnings have been issued with regard to abatacept. On the product label of abatacept, the FDA warns against known safety implications reporting, "In controlled clinical trials, patients receiving concomitant abatacept and TNF antagonist therapy experienced more infections (63%) and serious infections (4.4%) compared to patients treated with only TNF antagonists (43% and 0.8%, respectively). Concurrent administration of a TNF antagonist with abatacept has been associated with an increased risk of serious infections and no statistically significant additional benefit over use of the TNF antagonists alone" (FDA 2007). Furthermore, the FDA reports that, "rare occurrences of anaphylaxis or anaphylactoid reactions have been observed in two of 2,688 patients treated with abatacept in clinical trials" (FDA 2007). Trials have also shown that, "COPD patients treated with abatacept developed adverse events more frequently than those treated with placebo, including COPD exacerbations, cough, rhonchi, and dyspnea" (FDA 2007).

The effects of abatacept on pregnant women, pediatric patients, and the development of malignancies is "not yet fully understood" (FDA 2007). The European Medicines Agency (EMA) reports the adverse reactions in patients treated with abatacept, ranking the occurrences of such reactions as very common (≤ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100); rare (≥ 1/10,000 to < 1/1,000); and very rare (< 1/10,000). EMA 2009a reports increase in blood pressure, abnormal liver function test (transaminases increased) and headaches are very common adverse reactions. Dizziness, cough, rash including dermatitis, diarrhea, nausea, dyspepsia, abdominal pain, lower respiratory tract infection (including bronchitis), urinary tract infection, herpes simplex, upper respiratory tract infection, hypertension, flushing, fatigue and asthenia are common (EMA 2009a). Overall, "the most commonly reported adverse events (occurring in 10% or more of patients) were headaches, upper respiratory tract infection, nasopharyngitis, and nausea. The adverse events most commonly resulting in clinical intervention were due to infection" (FDA 2007).

Adalimumab

The updated 2008 FDA label for adalimumab reports "Serious infections, sepsis, tuberculosis and cases of opportunistic infections, including fatalities, have been reported with the use of TNF blocking agents including Humira® [adalimumab]" (FDA 2008b). "Other serious infections seen in clinical trials include pneumonia, pyelonephritis, septic arthritis and septicaemia. Hospitalization or fatal outcomes associated with infections have been reported" (EMA 2009b). Furthermore, hepatitis B reactivation has been shown to be associated with adalimumab treatment (Health Canada 2006a). The FDA reports, "As observed with other TNF blocking agents, tuberculosis associated with the administration of Humira® in clinical trials has been reported" (FDA 2008b).

In rare instances, adalimumab has been associated with, "new onset or exacerbation of clinical symptoms and/or radiographic evidence of demyelinating disease including multiple sclerosis" (EMA 2009b). Furthermore, "In the controlled portions of clinical trials of some TNF‐blocking agents, including Humira, more cases of malignancies have been observed among patients receiving those TNF blockers compared to control patients" (FDA 2008b).

"Some of these hepatosplenic T‐cell lymphomas have occurred in young adult patients on concomitant treatment with azathioprine or 6‐mercaptopurine used for Crohn’s disease". Thus, the risk of the development of hepatosplenic T‐cell lymphoma cannot be excluded for patients treated with adalimumab (EMA 2009b). Though the causal relationship of hematological reactions and the use of adalimumab remain unclear as of 2008, the FDA label states, "Rare reports of pancytopenia including aplastic anemia have been reported with TNF blocking agents". Furthermore, the FDA reports "Treatment with Humira® [adalimumab] may result in the formation of autoantibodies and, rarely, in the development of a lupus‐like syndrome" (FDA 2008b).

Anakinra

Anakinra leads to an increased rate of infections (2%) versus placebo (less than 1%). Following the EMEA standard of classification of frequency of the occurrence of "undesirable effects" mentioned above, neutropenia and serious infection requiring hospitalization were common (between 1/10 and 1/100) and headaches and injection site reactions were very common occurring in 1/10 or more patients treated with anakinra (EMA 2004). "A… clinical trial sponsored by Amgen Inc. showed a higher incidence of serious infection and of neutropenia in anakinra and etanercept combination group than patients receiving Enbrel [etanercept] alone and higher than observed in previous trials where Kineret [anakinra] was used alone (EMA 2003), therefore, the use of etanercept and anakinra is not recommended as it leads to safety complications)". Furthermore, the FDA reports in its most recent report on anakinra that "Hypersensitivity reactions associated with Kineret [anakinra] administration are rare" (FDA 2001). Moreover, the FDA reports the effects of anakinra on the hematologic conditions of patients stating that, "In placebo‐controlled studies with Kineret® [anakinra], treatment was associated with small reductions in the mean values for total white blood count, platelets, and absolute neutrophil count (ANC), and a small increase in the mean eosinophil differential percentage" (FDA 2001). With regard to the development of malignancies for patients treated with anakinra, trials show that, "among 5300 RA patients treated with Kineret [anakinra] clinical trials for a mean of 15 months (approximately 6400 patient years of treatment), lymphomas were observed for a rate of 0.12 cases per 100 patient years. This is 3.6 fold higher than the rate of lymphomas expected in the general population, based on the National Cancer Institutes Surveillance Epidemiology and End Results (SEER) database" (FDA 2001).

Etanercept

In the post‐marketing reports of etanercept, "Infections, including serious infections leading to hospitalization or death, have been observed in patients treated with Enbrel® [etanercept]" (FDA 2008d). Furthermore, "Data from clinical trials and preclinical studies suggest that the risk of reactivation of latent tuberculosis infection is lower with Enbrel® than with TNF‐blocking monoclonal antibodies. Nonetheless, post‐marketing cases of tuberculosis reactivation have been reported for TNF blockers, including Enbrel® [etanercept]. Patients receiving Enbrel® should be monitored closely for signs and symptoms of active tuberculosis. The possibility of tuberculosis should be considered, especially in patients who have travelled to countries with a high prevalence of tuberculosis or had close contact with a person with active tuberculosis. All patients treated with Enbrel® should have a thorough history taken prior to initiating therapy" (FDA 2008d). This finding is also stated in an important health warning issued by Health Canada in 2006 (Health Canada 2006a).

Furthemore, etanercept has been associated with the risk of histoplasmosis and other invasive fungal infections. Health Canada 2009 states, "...although no histoplasmosis infections were reported among 17,696 patients from the United States and Canada who were treated with Enbrel®, in 38 clinical trials and four cohort studies involving all authorized indications, post marketing cases of serious and sometimes fatal fungal infections, including histoplasmosis, have been reported with TNF blockers, including Enbrel®." The FDA also outlines the risk of nervous system complications stating, "nervous system complications such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes have occurred in rare cases" (FDA 2008d).

Infections, including serious infections leading to hospitalization or death, have been observed in patients treated with Enbrel® [etanercept] (FDA 2008d). The FDA reports on the risk of malignancies for patients on etanercept treatment, stating "Patients have been observed in clinical trials with Enbrel® for over five years. Among 4462 rheumatoid arthritis patients treated with Enbrel® in clinical trials for a mean of 27 months (approximately 10000 patient‐years of therapy), lymphomas were observed for a rate of 0.09 cases per 100 patient‐years. This is 3‐fold higher than the rate of lymphomas expected in the general population based on the Surveillance, Epidemiology, and End Results Database. Rare reports of pancytopenia including aplastic anemia, some with a fatal outcome, have been reported in patients treated with Enbrel®" (FDA 2008d). The FDA also reports, "Treatment with Enbrel® may result in the formation of autoantibodies and, rarely, in the development of a lupus‐like syndrome or autoimmune hepatitis which may resolve following withdrawal of Enbrel®" (FDA 2008d).

The use of etanercept has also been associated with the relapse of hepatitis B (Health Canada 2006a).

Infliximab

In its recent revised report on infliximab, the EMEA reports on the risk of infusion reactions and hypersensitivity, stating, "An infusion‐related reaction was defined in clinical studies as any adverse event occurring during an infusion or within 1 to 2 hours after an infusion. In clinical studies, approximately 20% of infliximab‐treated patients compared with approximately 10% of placebo‐treated patients experienced an infusion‐related effect. Approximately 3% of patients discontinued treatment due to infusions reactions" (EMA 2009a). Infliximab is also associated with the relapse of hepatitis B as reported by Health Canada in 2006 (Health Canada 2006a). "Opportunistic infections have been reported in patients treated with infliximab, suggesting that host defence against infection is compromised. It should be noted that suppression of TNF‐alpha may also mask symptoms of infection such as fever." There is also a possible association between infliximab and heptosplenix T‐Cell lymphoma in pediatric and young adult patients with Crohn’s disease (Health Canada 2006b).

"In a study designed to evaluate Remicade® [infliximab] in congestive heart failure (CHF), 150 patients with moderate to severe (NYHA class II‐IV) CHF were treated with three infusions of Remicade 5mg/ kg, or placebo over six weeks. Higher incidences of mortality and hospitalization for worsening heart failure were seen in those patients treated with Remicade®, especially have treated with the higher dose of 10mg/kg. At present 7 out of 101 patients treated with Remicade® have died compared to no deaths among 49 patients on placebo" (EMA 2001). In a May 2009 revision of the Remicade label, the FDA warns, "Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving TNF‐ blocking agents. Among opportunistic infections, tuberculosis, histoplasmosis, aspergillosis, candidiasis, coccidioidomycosis, listeriosis, and pneumocystosis were the most commonly reported. Patients have frequently presented with disseminated rather than localized disease, and are often taking concomitant immunosuppressants such as methotrexate or corticosteroids with Remicade®" (FDA 2009a). In an investigation of neurological events, EMEA reports "Infliximab and other agents that inhibit TNF‐alpha have been associated in rare cases with optic neuritis, seizure and new onset or exacerbation of clinical symptoms and/or radiographic evidence of central nervous system demyelinating disorders, including multiple sclerosis, and peripheral demyelinating disorders, including Guillain‐Barré syndrome" (EMA 2009a).

The increased risk of developing lymphoma is also reported. FDA archived report from October 2004 on infliximab safety alerts notifies that

"During the controlled portions of REMICADE trials in patients with moderately to severely active rheumatoid arthritis and Crohn's disease, 1 patient developed lymphoma among 1389 REMICADE‐treated patients versus 0 among 483 control patients (median duration of follow‐up 1.1 years).” “ In the controlled and open‐label portions of these clinical trials of REMICADE, 3 patients developed lymphomas (1 patient with rheumatoid arthritis and 2 patients with Crohn’s disease) among 2410 patients (median duration of follow‐up 1.1 years).” “As a result of this evaluation, a warning concerning malignancy has been added to the labelling for all therapeutic agents that block TNF.”(FDA 2004).

Another evidence of infliximab associated with lymphoma states that "In the controlled portions of clinical trials of all the TNF‐blocking agents, more cases of lymphoma have been observed among patients receiving a TNF blocker compared with control patients… In the combined clinical trial population for rheumatoid arthritis, Crohn's disease, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis, and plaque psoriasis, lymphomas were observed for a rate of 0.10 cases per 100 patient‐years of follow‐up, which is approximately 4‐fold higher than expected in the general population. Patients with Crohn's disease, rheumatoid arthritis or plaque psoriasis, particularly patients with highly active disease and/or chronic exposure to immunosuppressant therapies, may be at a higher risk (up to several fold) than the general population for the development of lymphoma, even in the absence of TNF‐blocking therapy" (EMA 2009a).

TNF‐blockers as a group

In 2008, the FDA issued a safety alert regarding anti‐TNF biologics, which stated that the risk of pulmonary and disseminated histoplasmosis, coccidioidomycosis, blastomycosis and other opportunistic infections were not consistently recognized in patients taking tumor necrosis factor‐alpha blockers (TNF blockers including etanercept, adalimumab, infliximab or certolizumab), which resulted in the delay of proper antifungal treatment and at times led to death (FDA 2008c). The FDA reviewed 240 reports of histoplasmosis, an infection caused by the fungus Histoplasma capsulatum, in patients being treated with Enbrel, Humira, or Remicade. The majority of the reports involved people in the Ohio River and Mississippi River valleys (the fungus is commonly found in those areas). In at least 21 of the reports, histoplasmosis was initially not recognized by healthcare professionals, and antifungal treatment was delayed. Twelve of those patients died. The FDA recommended that for patients at risk of histoplasmosis and other invasive fungal infections, clinicians should consider empiric antifungal treatment until the pathogen(s) are identified. In 2004, the FDA issues a safety alert regarding risk of cancer with anti‐TNF biologics (FDA 2004). According to the FDA "In the controlled portions of clinical trials of all the TNFα‐blocking agents, more cases of lymphoma have been observed among patients receiving a TNF blocker compared with control patients. During the controlled portions of REMICADE trials in patients with moderately to severely active rheumatoid arthritis and Crohn's disease, 1 patient developed lymphoma among 1389 REMICADE‐treated patients versus 0 among 483 control patients (median duration of follow‐up 1.1 years). In the controlled and open‐label portions of these clinical trials of REMICADE, 3 patients developed lymphomas (1 patient with rheumatoid arthritis and 2 patients with Crohn’s disease) among 2410 patients (median duration of follow‐up 1.1 years). In rheumatoid arthritis patients, this is approximately 3‐fold higher than expected in the general population. In the combined clinical trial population for rheumatoid arthritis and Crohn’s disease, this is approximately 6‐fold higher than expected in the general population."

Rituximab

While no reviews exist for rituximab in the EMEA web site and Health Canada’s reviews are outdated, the FDA provides its most recent safety information for Rituxan® [rituximab] from 2009. Rituxan was found to be associated with progressive multifocal leukoencephalopathy. FDA and Genetech notified: "A third case of progressive multifocal leukoencephalopathy (PML) has been reported in a patient with rheumatoid arthritis treated with Rituxan.” In view of this event, Genetech has advised physicians to have high index of suspicion for PML stated as “Physicians should consider PML in any patient being treated with Rituxan who presents with new onset neurologic manifestations. Consultation with a neurologist, brain MRI, and lumbar puncture should be considered as clinically indicated. In patients who develop PML, Rituxan should be discontinued.” (FDA 2009b). Another event associated with Rituxan was notified in a FDA label from 2008.In this label, the possible safety complications of Rituxan® use included "tumor lysis syndrome which necessitates clinicians to administer prophylaxis and monitor patients renal function, hepatitis B reactivation with fulminant hepatitis, which can sometimes [be] fatal and the risk of progressive multifocal leukoencephalopathy" (Drugs 2006).

FDA and Genentech informed healthcare professionals of important emerging safety information about Rituxan®. "Two patients died after being treated with Rituxan® for systemic lupus erythematosus (SLE). Rituxan® is approved for the above indication and is prescribed off‐label for other serious diseases and conditions such as SLE. The cause of death was progressive multifocal leukoencephalopathy, a viral infection of the brain (that is caused by reactivated JC virus which is present in about 80% of adults" (FDA 2006). Further risks include "cardiac arrhythmias and angina" which can be life threatening, and "bowel obstruction and perforation" (FDA 2008d). Health Canada 2006a also provided warnings of bowel obstruction and perforation, "Reports of abdominal pain, bowel obstruction, and perforation, in some cases leading to death, have been observed in patients receiving Rituxan®. The majority of reports, including all deaths, have occurred in patients receiving Rituxan in combination with chemotherapy for NHL [(non‐Hodgkin’s Lymphoma)] indication. A causal relationship has not been established".

Tofacitinib

The FDA issued a Risk Evaluation and Mitigation Strategy (REMS) document, a modification in February 2015 to the original 11/2012 document, highlighting the known concerns with tofacitinib, instructing the pharmaceutical company to send information to physicians and pharmacists regarding the risk of serious infections, malignancies, decreases in peripheral lymphocyte counts, neutrophil counts, hemoglobin, and increases in lipid parameters in peripheral blood with XELJANZ (tofacitinib) (FDA 2015).

Study flow diagram
Figuras y tablas -
Figure 1

Study flow diagram

Network diagram for ACR50 in people with RA who are biologic‐experienced
Figuras y tablas -
Figure 2

Network diagram for ACR50 in people with RA who are biologic‐experienced

ACR50: biologic monotherapy vs. placebo
Figuras y tablas -
Figure 3

ACR50: biologic monotherapy vs. placebo

ACR50: biologic with MTX vs. MTX/DMARD
Figuras y tablas -
Figure 4

ACR50: biologic with MTX vs. MTX/DMARD

HAQ: biologic with MTX vs. MTX/DMARD
Figuras y tablas -
Figure 5

HAQ: biologic with MTX vs. MTX/DMARD

RA remission: biologic with MTX vs. MTX/DMARD
Figuras y tablas -
Figure 6

RA remission: biologic with MTX vs. MTX/DMARD

Withdrawals due to adverse events: biologic monotherapy vs. placebo
Figuras y tablas -
Figure 7

Withdrawals due to adverse events: biologic monotherapy vs. placebo

Withdrawals due to adverse events: biologic with MTX vs. MTX/DMARD
Figuras y tablas -
Figure 8

Withdrawals due to adverse events: biologic with MTX vs. MTX/DMARD

Serious adverse events: biologic with MTX vs. MTX/DMARD
Figuras y tablas -
Figure 9

Serious adverse events: biologic with MTX vs. MTX/DMARD

Table 1. Characteristics of included studies

Study name

Biologic(s)

Biologic dose(s)

Number of study arms

Non‐biologic comparator

Concomitant use of MTX/DMARD

Trial duration

RA duration

Biologic‐naive

Which biologic failed?

Reason(s) for previous biologic‐failure

DMARD‐naïve

Mono‐biologic

Total number of participants

Bingham 2015

Tocilizumab

HD

2

MTX

Yes

5 months

Late

Yes

≥ 1 TNF‐biologic

Inefficacy or intolerance

No

Yes

91

Burmester 2013

Tofacitinib

SD, HD

3

MTX + PL

Yes

3 months

Late

No

TNF‐biologic

Inadequate response

No

Yes

399

Cohen 2006 (REFLEX)

Rituximab

SD

2

MTX + PL

Yes

24 months

Late

No

≥ 1 TNF‐biologic

Inadequate response

No

Yes

520

Emery 2008a (RADIATE)

Tocilizumab

SD, HD

3

MTX + PL

Yes

6 months

Late

No

≥ 1 TNF‐biologic

Inefficacy or intolerance

No

Yes

498

Furst 2007

Etanercept/infliximab

SD

2

None

Yes

7 months

Established

No

Etanercept

Partial response

No

No

27

Genovese 2005

Abatacept

SD

2

PL

No

6 months

Late

No

≥ 1 TNF‐biologic

Inadequate response

No

Yes

389

Keystone 2008 (REFLEX)

Rituximab

SD

2

MTX + PL

Yes

24 months

Late

No

≥ 1 TNF‐biologic

Inadequate response

No

Yes

499

Moreland 2002

Abatacept

SD, LD, HD

4

PL

No

3 months

Established

No

Etanercept

Inadequate response

No

Yes

122

Schiff 2014b

Certolizumab

SD

2

PL

No

3 months

Late

No

TNF‐biologic except certolizumab

Secondary Inadequate response or intolerance

No

Yes

37

Smolen 2009

(GO‐AFTER)

Golilumab

SD, HD

3

DMARD + PL

Yes

6 months

Established

No

TNF‐biologic‐ etanercept, infliximab or adalimumab

Inadequate response (58%) or intolerance (53%)

No

Yes

461

Weinblatt 2007a

Abatacept/etanercept

SD, LD

2

None

No

12 months

Late

No

Etanercept

Inadequate response

No

No

121

Weinblatt 2008

Etanercept

SD, HD

2

None

No

3 months

Late

No

Etanercept 50 mg weekly

Inadequate response

No

Yes

200

DMARD: disease‐modifying anti‐rheumatic drug
HD: high dose
LD: low dose
MTX: methotrexate
PL: placebo
RA duration: established = mean/median duration 2 to 10 years; late = mean/median duration > 10 years
SD: standard dose

Figuras y tablas -
Table 1. Characteristics of included studies
Table 2. Characteristics of excluded studies

Study

Reason for exclusion

Abe 2006

Wrong drug exposure

Axelsen 2015

Duplicate of Hørslev‐Petersen 2014

Bae 2013

Wrong drug exposure

Bathon 2000

Duplicate of Genovese 2002

Bejarano 2008

Wrong drug exposure

Bonafede 2015

Not a RCT

Boyle 2015

Wrong exposure

Breedveld 2006

Wrong drug exposure

Bresnihan 1998

Wrong drug exposure

Burmester 2014

Wrong drug exposure

Burmester 2015

Wrong drug exposure

Chen 2009

Wrong drug exposure

Cheng 2014

Conference abstract

Choy 2012

Wrong drug exposure

Cohen 2002

Wrong drug exposure

Cohen 2003

Wrong drug exposure

Cohen 2004

Wrong drug exposure

Combe 2006

Wrong drug exposure

Combe 2009

Wrong drug exposure

Conaghan 2013

Wrong drug exposure

Conaghan 2014

Sub‐study of Huizinga 2015

Coombs 2010

Wrong drug exposure

Detert 2013

Wrong drug exposure

Dougados 2013

Wrong drug exposure

Dougados 2014

Duplicate of Huizinga 2015

Doyle 2013

Wrong drug exposure

Durez 2004

Wrong drug exposure

Durez 2007

Wrong drug exposure

Edwards 2004

Wrong drug exposure

Emery 2006

Wrong drug exposure

Emery 2008a

Wrong drug exposure

Emery 2010

Wrong drug exposure

Emery 2014a

Duplicate

Emery 2014b

Conference abstract

Eriksson 2015

Follow‐up at two years of Van Vollenhoven 2012a NCT00764725

Fleischmann 2003

Wrong drug exposure

Fleischmann 2009

Wrong drug exposure

Fleischmann 2012a

Wrong drug exposure

Fleischmann 2012b

Wrong drug exposure

Fleischmann 2013

Conference abstract

Furst 2003

Wrong drug exposure

Furst 2015

Open label study

Gabay 2013

Wrong drug exposure

Gashi 2014

Comparing two doses of a biologic

Genovese 2002

Wrong drug exposure

Genovese 2004

Wrong drug exposure

Genovese 2008

Wrong drug exposure

Genovese 2011

Wrong drug exposure

Genovese 2015

Wrong drug exposure

Gherge 2014

Conference abstract

Goekoop‐Ruiterman 2007

Wrong drug exposure

Haraoui 2014

Duplicate of Pope 2014

Heimans 2014

Wrong drug exposure

Hobbs 2015

Wrong drug exposure

Hørslev‐Petersen 2014

Open label study

Huizinga 2015

Discontinuation study

Iannone 2014

Open label study

Jobanputra 2012

Wrong drug exposure

Johnsen 2006

Wrong drug exposure

Jones 2010

Wrong drug exposure

Kaine 2011

Wrong drug exposure

Kameda 2010

Wrong drug exposure

Kameda 2011

Wrong drug exposure

Kavanaugh 2013

Wrong drug exposure

Kavanaugh 2014

Conference abstract

Kay 2008

Wrong drug exposure

Kennedy 2014

Wrong drug exposure

Keystone 2004a

Wrong drug exposure

Keystone 2004b

Wrong drug exposure

Keystone 2009

Wrong drug exposure

Keystone 2014

Conference abstract

Kim 2007

Wrong drug exposure

Kim 2012

Wrong drug exposure

Kim 2013

Wrong drug exposure

Kivitz 2014

Vaccine response study

Koroleva 2014a

Conference abstract

Koroleva 2014b

Conference abstract

Kremer 2003

Wrong drug exposure

Kremer 2005

Wrong drug exposure

Kremer 2006

Wrong drug exposure

Kremer 2009

Wrong drug exposure

Kremer 2010

Wrong drug exposure

Kremer 2011

Wrong drug exposure

Kremer 2012

Wrong drug exposure

Kremer 2013

Wrong drug exposure

Kremer 2015

Cross over study design

Lan 2004

Wrong drug exposure

Landewé 2015

Conference abstract

Lipsky 2000

Wrong drug exposure

Lisbona 2008

Wrong drug exposure

Lisbona 2010

Wrong drug exposure

Machado 2014

Wrong drug exposure

Maini 1999

Wrong drug exposure

Maini 2006

Wrong drug exposure

Manders 2015

Trial participants switched therapy within one year/before completion of study period

Mathias 2000

Wrong drug exposure

McInnes 2015

Compared lipid levels in those randomized to CZP or PL, in MTX‐IR participants

Miyasaka 2008

Wrong drug exposure

Moreland 1999

Wrong drug exposure

Nam 2014a

Wrong drug exposure

Nam 2014b

Wrong drug exposure

Navarro 2014

Conference abstract

Nishimoto 2004

Wrong drug exposure

Nishimoto 2007

Wrong drug exposure

Nishimoto 2009

Wrong drug exposure

O'Dell 2013

Wrong drug exposure

Oakley 2014

Conference abstract

Pavelka 2013

Sub‐group analysis of Smolen 2013 NCT00565409

Pope 2014

Wrong drug exposure

Quinn 2005

Wrong drug exposure

Rantalaiho 2014

Wrong drug exposure

Rau 2004

Wrong drug exposure

Rigby 2011

Duplicate of Tak 2011

Rubbert‐Roth 2010

Wrong drug exposure

Schiff 2008

Wrong drug exposure

Schiff 2013

Wrong drug exposure

Smolen 2008

Wrong drug exposure

Smolen 2013

Wrong drug exposure

Smolen 2014b

Participants in the control group also received the intervention

Smolen 2015

Wrong drug exposure

Sonomoto 2014

Open label study

Soubrier 2009

Wrong drug exposure

St Clair 2004

Wrong drug exposure

Strand 2006

Wrong drug exposure

Strand 2012

Wrong drug exposure

Tada 2012

Wrong drug exposure

Tak 2011

Wrong drug exposure

Tak 2012

Wrong drug exposure

Takeuchi 2013a

Wrong drug exposure

Takeuchi 2013b

Wrong drug exposure

Takeuchi 2013c

Wrong drug exposure

Takeuchi 2014

Wrong drug exposure

Tam 2012

Wrong drug exposure

Tanaka 2011

Wrong drug exposure

Tanaka 2012

Wrong drug exposure

Taylor 2004

Wrong drug exposure

Taylor 2006

Wrong drug exposure

Van de Putte 2003

Wrong drug exposure

Van de Putte 2004

Wrong drug exposure

Van der Heidje 2006

Wrong drug exposure

Van der Heidje 2007

Wrong drug exposure

Van Der Heijde 2013

Wrong drug exposure

Van der Kooij 2009

Wrong drug exposure

Van Riel 2006

Wrong drug exposure

Van Vollenhoven 2009

Wrong drug exposure

Van Vollenhoven 2012a

Duplicate of Van Vollenhoven 2009

Van Vollenhoven 2012b

Wrong drug exposure

Vital 2015

B cell depletion study

Weinblatt 1999

Wrong drug exposure

Weinblatt 2003

Wrong drug exposure

Weinblatt 2006

Wrong drug exposure

Weinblatt 2012

Wrong drug exposure

Weinblatt 2013a

Wrong drug exposure

Weinblatt 2013b

Wrong drug exposure

Weinblatt 2014

Results at 1 year of Weinblatt 2013b GO‐FURTHER trial, NCT00973479

Weisman 2003

Wrong drug exposure

Weisman 2007

Wrong drug exposure

Westhovens 2006

Wrong drug exposure

Westhovens 2009

Wrong drug exposure

Westhovens 2014

Conference abstract

Yamamoto 2014a

Wrong drug exposure

Yamamoto 2014b

Wrong drug exposure

Yamanaka 2014

Post hoc analysis of Takeuchi 2014

Yazici 2012

Wrong drug exposure

Zhang 2006

Wrong drug exposure

Østergaard 2015

Wrong drug exposure

CZP: certolizumab pegol
MTX‐IR: methotrexate incomplete responders
PL: placebo

Figuras y tablas -
Table 2. Characteristics of excluded studies
Table 3. 'Summary of findings' table for biologics vs. comparator in people previously unsuccessfully treated with biologics (all participants: 1 or more TNF‐biologic failed)

Comparison

No. of participants (studies)

Direct evidence

Network meta‐analysis

Absolute risk difference, NNTB

Quality of evidence

Absolute risk difference, NNTB

Quality of evidence

Outcome: ACR50

RR (95% CI)

RR (95% Crl)

All biologics

vs. placebo

548

(3 studies)

4.10 (1.97 to 8.55)

14% (6% to 21%), NNTB = 8 (4 to 23)

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

n/a

All biologics + MTX

vs. MTX/DMARD

1479

(3 studies)

4.07 (2.76 to 5.99)

16% (10% to 21%), NNTB = 7 (5 to 11)

⊕⊕⊕⊕ highb

n/a

TNF biologic + MTX

vs. MTX/DMARD

461

(1 study)

2.84 (1.49 to 5.40)

12% (6% to 18%), NNTB = 9 (5 to 25)

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

2.97 (1.38 to 6.41)

10% (2% to 25%), NNTB = 10 (4 to 48)

⊕⊕⊕⊖ moderate (downgraded for indirectness)c

Non‐TNF biologic + MTX

vs. MTX/DMARD

1018

(2 studies)

4.99 (3.07 to 8.11)

18% (10% to 25%), NNTB = 6 (4 to 10)

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

5.07 (3.21 to 8.14)

21% (13% to 30%), NNTB = 5 (3 to 9)

⊕⊕⊕⊖ moderate (downgraded for indirectness)c

Tofacitinib + MTX

vs. MTX/DMARD

399

(1 study)

3.24 (1.78 to 5.89)

19% (12% to 26%), NNTB = 6 (3 to 14)

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

3.61 (1.74 to 7.24)

13% (4% to 29%), NNTB = 8 (4 to 25)

⊕⊕⊕⊖ moderate (downgraded for indirectness)c

Outcome: Health Assessment Questionnaire (HAQ) score,

0‐3 (higher = worse; A "negative sign" indicates improvement): A measure of function

MD (95% CI)

All biologics

vs. placebo

n/a

All biologics + MTX

vs. MTX/DMARD

959

(2 studies)

‐0.29 (‐0.36 to ‐0.21)

‐9.7% (‐12% to ‐7.0%), NNTB = 5 (4 to 7)

⊕⊕⊕⊕ highb

n/a

TNF biologic + MTX

vs. MTX/DMARD

461

(1 study)

‐0.25 (‐0.40 to ‐0.10)

‐8.3% (‐13% to ‐3%), NNTB = 5 (7 to 16)

⊕⊕⊕⊕ highb

‐0.37 (‐6.67 to 5.89)

‐12.3% (‐222.3% to 196.3%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for imprecision and indirectness)c,d

Non‐TNF biologic + MTX

vs. MTX/DMARD

498

(1 study)

‐0.37 (‐0.46 to ‐0.28)

‐12.3% (‐15% to ‐9%), NNTB = 4 (3 to 5)

⊕⊕⊕⊕ highb

‐0.25 (‐6.54 to 5.99)

‐8.3% (‐218% to 199.7%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for imprecision and indirectness)c,d

Tofacitinib + MTX

vs. MTX/DMARD

399

(1 study)

‐0.27 (‐0.39 to ‐0.14)

‐9% (‐13% to ‐4.7%), NNTB = 5 (4 to 10)

⊕⊕⊕⊕ highb

‐0.26 (‐6.57 to 5.95)

‐8.7% (‐219% to 198.3%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for imprecision and indirectness)c,d

Outcome: Remission

(defined as DAS <1.6 or DAS28 <2.6)

RR (95% CI)

RR (95% CI)

All biologics

vs. placebo

389 (1 study)

13.51 (1.85 to 98.45)

9% (5% to 13%), NNTB = 11 (3 to 136)

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

n/a

All biologics + MTX

vs. MTX/DMARD

959

(2 studies)

20.73 (4.13 to 104.16)

10% (8% to 13%), NNTB = 17 (4 to 96)

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

n/a

TNF biologic + MTX

vs. MTX/DMARD

461

(1 study)

16.21 (2.24 to 117.51)

10% (6% to 13%), NNTB = 11 (3 to 110)

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

22.27 (3.60 to 400.70)

8% (1% to 52%), NNTB = 9 (2 to 61)

⊕⊕⊕⊖ moderate (downgraded for indirectness)c

Non‐TNF biologic + MTX

vs. MTX/DMARD

498

(1 study)

33.72 (2.08 to 546.23)

10% (7% to 14%), NNTB = n/ae

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

31.20 (6.70 to 456.30)

11% (3% to 32%), NNTB = 18 (3 to 93)

⊕⊕⊕⊖ moderate (downgraded for indirectness)c

Tofacitinib + MTX

vs. MTX/DMARD

398

(1 study)

15.44 (0.93 to 256.10)

6% (3% to 9%), NNTB = n/ae

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

n/a

Outcome: Radiographic progression

No studies reported this outcome.

Outcome: Withdrawals due

to adverse events

RR (95% CI)

RR (95% CI)

All biologics

vs. placebo

428

(2 studies)

0.62 (0.13 to 2.93)

‐1% (‐4% to 3%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,e

n/a

All biologics + MTX

vs. MTX/DMARD

611

(2 studies)

3.32 (0.86 to 12.85)

5% (‐3% to 13%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,e

n/a

TNF biologic + MTX

vs. MTX/DMARD

n/a

Non‐TNF biologic + MTX

vs. MTX/DMARD

611

(2 studies)

3.32 (0.86 to 12.85)

5% (‐4% to 13%), NNTB = n/a

⊕⊖⊖⊖ very low (downgraded for serious imprecision/inconsistency)a,d,f

1.99 (0.80 to 5.98)

3% (‐1% to 8%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for imprecision and indirectness)c,d

Tofacitinib + MTX

vs. MTX/DMARD

399

(1 study)

0.99 (0.41 to 2.39)

0% (‐5% to 5%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,d

1.02 (0.29 to 3.65)

0% (‐2% to 6%), NNTB = n/a

⊕⊕⊖c low (downgraded for imprecision and indirectness)c,d

Outcome: Serious adverse

events

RR (95% CI)

RR (95% CI)

All biologics

vs. placebo

428

(2 studies)

0.93 (0.51 to 1.68)

‐1% (‐7% to 5%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,d

n/a

All biologics + MTX

vs. MTX/DMARD

1072

(3 studies)

0.69 (0.44 to 1.09)

‐2% (‐5% to 1%), NNTB = n/a

⊕⊕⊕⊖ moderate (downgraded for imprecision)a

n/a

TNF biologic + MTX

vs. MTX/DMARD

461

(1 study)

0.55 (0.25 to 1.22)

‐3% (‐8% to 1%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,d

0.56 (0.20 to 1.51)

‐3% (‐6% to 3%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for imprecision and indirectness)c,d

Non‐TNF biologic + MTX

vs. MTX/DMARD

611

(2 studies)

0.77 (0.45 to 1.33)

‐1% (‐6% to 3%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,d

0.85 (0.49 to 1.53)

‐1% (‐4% to 3%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for imprecision and indirectness)c,d

Tofacitinib + MTX

vs. MTX/DMARD

399

(1 study)

0.33 (0.09 to 1.15)

‐3% (‐7% to 1%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,d

0.32 (0.07 to 1.27)

‐4% (‐8% to 2%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for imprecision and indirectness)c,d

Outcome: Cancer

(note: Peto OR used but

can interpret as RR due

to low event rate)

RR (95% CI)

RR (95% CI)

All biologics

vs. placebo

n/a

All biologics + MTX

vs. MTX/DMARD

550

(2 studies)

4.54 (0.24 to 85.36)

1% (‐1% to 2%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,d

n/a

TNF biologic + MTX

vs. MTX/DMARD

459

(1 study)

4.54 (0.24 to 85.36)

1% (‐1% to 2%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,d

Non‐TNF biologic + MTX

vs. MTX/DMARD

91

(1 study)

Not estimable

0% (‐5% to 5%), NNTB = n/a

⊕⊕⊖⊖ low (downgraded for serious imprecision)a,d

Tofacitinib + MTX

vs. MTX/DMARD

n/a

Note ‐ no studies reported radiographic progression for either biologic or tofacitinib.

High quality (⊕⊕⊕⊕): we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality (⊕⊕⊕⊖): we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality (⊕⊕⊖⊖): our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low quality (⊕⊖⊖⊖): we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

CI: confidence interval; CrI: credible interval; DAS: Disease Activity Score; DMARD: disease‐modifying anti‐rheumatic drug; MD: mean difference; MTX: methotrexate; n/a: not available; NNTB: number needed to treat for an additional beneficial outcome; RR: risk ration; TNF: tumor necrosis factor

Comparator = placebo and/or MTX and/or DMARD

aDowngraded for imprecision ‐ few events (< 300).
bNo evidence of imprecision or inconsistency. Number of events > 300.
cDowngraded for indirectness/intransitivity due to differing participant characteristics (established vs. late RA; types of failures); differing biologic doses and co‐interventions; and differing comparators.
dDowngraded for imprecision ‐ 95% CI estimate includes both null effect and appreciable benefit or harm.
eCould not be calculated, control event % = 0.
f I2 = 73% ‐ downgraded for inconsistency

Figuras y tablas -
Table 3. 'Summary of findings' table for biologics vs. comparator in people previously unsuccessfully treated with biologics (all participants: 1 or more TNF‐biologic failed)
Table 4. ACR50 analysis for the type of medication (MTX/DMARD active comparator): odds ratios (OR), risk ratios (RR) and risk difference (RD) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

OR (95% CrI)

RR (95% CrI)

RD (95% Crl)

(MTX or DMARD) + non‐TNF

Comparator

6.48 (3.76 to 11.66)

5.07 (3.21 to 8.14)

0.21 (0.13 to 0.30)

(MTX or DMARD) + monoclonal antibodies against TNF

3.32 (1.41 to 8.65)

2.97 (1.38 to 6.41)

0.10 (0.02 to 0.25)

TOFA

4.20 (1.82 to 10.30)

3.61 (1.74 to 7.24)

0.13 (0.04 to 0.29)

(MTX or DMARD) + monoclonal antibodies against TNF

(MTX or DMARD) + non‐TNF

0.51 (0.18 to 1.54)

0.59 (0.24 to 1.38)

‐0.11 (‐0.24 to 0.08)

TOFA

0.65 (0.23 to 1.86)

0.71 (0.31 to 1.58)

‐0.07 (‐0.22 to 0.12)

TOFA

(MTX or DMARD) + monoclonal antibodies against TNF

1.26 (0.36 to 4.40)

1.21 (0.43 to 3.36)

0.03 (‐0.15 to 0.22)

Random‐effects model

Residual deviance

8.529 vs. 10 data point

Deviance information criteria

65.147

Fixed‐effect model

Residual deviance

8.129 vs. 10 data point

Deviance information criteria

64.307

Note:

Total participants

2267

Total studies

5

2‐arm

5

DMARD: disease‐modifying anti‐rheumatic drug
MTX: methotrexate
TOFA: tofacitinib
TNF: tumor necrosis factor

Figuras y tablas -
Table 4. ACR50 analysis for the type of medication (MTX/DMARD active comparator): odds ratios (OR), risk ratios (RR) and risk difference (RD) for all treatment comparisons ‐ random‐effects model
Table 5. ACR50 analysis by dose (MTX/DMARD active comparator): odds ratios (OR), risk ratios (RR) and risk difference (RD) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

OR (95% CrI)

RR (95% CrI)

RD (95% Crl)

MTX SD biologic

Comparator: MTX or DMARD

4.82 (2.94 to 8.08)

4.10 (2.64 to 6.51)

0.14 (0.09 to 0.20)

MTX HD biologic

7.12 (3.73 to 13.28)

5.55 (3.24 to 9.23)

0.21 (0.12 to 0.31)

MTX HD biologic

MTX SD biologic

1.47 (0.84 to 2.54)

1.35 (0.87 to 2.03)

0.07 (‐0.03 to 0.17)

Random‐effects model

Residual deviance

10.34 vs. 10 data points

Deviance information criteria

64.487

Fixed‐effect model

Residual deviance

11.64 vs. 10 data points

Deviance information criteria

64.41

Total participants

1868

Total studies

4

2‐arm

2

3‐arm

2

DMARD: disease‐modifying anti‐rheumatic drug
HD: high dose
MTX: methotrexate
SD: standard dose

Figuras y tablas -
Table 5. ACR50 analysis by dose (MTX/DMARD active comparator): odds ratios (OR), risk ratios (RR) and risk difference (RD) for all treatment comparisons ‐ random‐effects model
Table 6. ACR50 analysis by dose (placebo comparator): odds ratios (OR), risk ratios (RR) and risk difference (RD) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

OR (95% CrI)

RR (95% CrI)

RD (95% Crl)

SD

Comparator

3.88 (0.99 to 23.62)

3.41 (0.99 to 14.41)

0.11 (0.00 to 0.39)

HD

4.91 (1.10 to 33.03)

4.14 (1.09 to 17.12)

0.15 (0.01 to 0.47)

HD

SD biologic

1.24 (0.49 to 3.32)

1.19 (0.55 to 2.57)

0.03 (‐0.10 to 0.21)

Total participants

359

Total studies

3

HD: high dose
SD: standard dose

Figuras y tablas -
Table 6. ACR50 analysis by dose (placebo comparator): odds ratios (OR), risk ratios (RR) and risk difference (RD) for all treatment comparisons ‐ random‐effects model
Table 7. HAQ analysis (MTX/other DMARD active comparator) for the type of medication: mean difference (MD) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

MD (95% CrI)

(MTX or DMARD) + non‐TNF

Comparator: PL, MTX or DMARD

(MTX or DMARD) + medications targeting TNF

‐0.37 (‐6.67 to 5.89)

TOFA

‐0.26 (‐6.57 to 5.95)

(MTX or DMARD) + medications targeting TNF

(MTX or DMARD) + non‐TNF

‐0.12 (‐8.96 to 8.75)

TOFA

‐0.02 (‐8.82 to 8.80)

TOFA

(MTX or DMARD) + medications targeting TNF

0.11 (‐8.83 to 8.97)

Random‐effects model

Residual deviance

5.996 vs. 6 data points

Deviance information criteria

‐13.527

Fixed‐effect model

Residual deviance

6.009 vs. 6 data points

Deviance information criteria

‐13.496

Note: A Negative sign indicates improvement in function

Total participants

1358

Total studies

3

2‐arm

3

DMARD: disease‐modifying anti‐rheumatic drug
MTX: methotrexate
PL: placebo
TOFA: tofacitinib
TNF: tumor necrosis factor

Figuras y tablas -
Table 7. HAQ analysis (MTX/other DMARD active comparator) for the type of medication: mean difference (MD) for all treatment comparisons ‐ random‐effects model
Table 8. Remission analysis (MTX/DMARD active comparator) for the type of medication: odds ratios (OR), risk ratios (RR) and risk difference (RD) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

OR (95% CrI)

RR (95% CrI)

RD (95% Crl)

MTX + non‐TNF

Comparator

30.61 (6.46 to 346.20)

27.18 (6.13 to 262.70)

0.11 (0.03 to 0.28)

MTX + TNF

23.11 (3.60 to 548.90)

21.04 (3.53 to 287.20)

0.08 (0.01 to 0.52)

MTX + TNF

MTX + non‐TNF

0.75 (0.04 to 26.40)

0.77 (0.05 to 13.49)

‐0.03 (‐0.26 to 0.47)

Random‐effects model

Residual deviance

5.167 vs. 6 data points

Deviance information criteria

30.949

Fixed‐effect model

Residual deviance

5.271 vs. 6 data points

Deviance information criteria

31.163

Note:

Total participants

1348

Total studies

3

2‐arm

2

3‐arm

1

MTX: methotrexate
TNF: tumor necrosis factor

Figuras y tablas -
Table 8. Remission analysis (MTX/DMARD active comparator) for the type of medication: odds ratios (OR), risk ratios (RR) and risk difference (RD) for all treatment comparisons ‐ random‐effects model
Table 9. Remission: analysis (MTX/other DMARD active comparator trials) by dose: odds ratio (OR) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

OR (95% CrI)

RR (95% CrI)

RD (95% Crl)

MTX SD

Comparator

14.92 (3.49 to 96.81)

14.03 (3.40 to 87.45)

0.06 (0.02 to 0.13)

MTX HD

54.62 (11.77 to 402.30)

43.97 (10.54 to 272.50)

0.18 (0.07 to 0.40)

MTX HD

MTX SD

3.62 (1.19 to 12.87)

3.10 (1.16 to 8.95)

0.13 (0.01 to 0.33)

Random‐effects model

Residual deviance

8.496 vs. 8 data points

Deviance information criteria

42.391

Fixed‐effect model

Residual deviance

14.72 vs. 8 data points

Deviance information criteria

46.982

Note:

Total participants

1348

Total studies

3

2‐arm

1

3‐arm

2

HD: high dose
MTX: methotrexate
SD: standard dose

Figuras y tablas -
Table 9. Remission: analysis (MTX/other DMARD active comparator trials) by dose: odds ratio (OR) for all treatment comparisons ‐ random‐effects model
Table 10. Withdrawals due to adverse events: analysis (MTX/other DMARD active comparator trials) for the type of medication: odds ratio (OR) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

OR (95% CrI)

RR (95% CrI)

RD (95% Crl)

MTX or DMARD + non‐TNF

Comparator

2.04 (0.80 to 6.49)

1.99 (0.80 to 5.98)

0.03 (‐0.01 to 0.08)

TOFA + MTX

1.02 (0.29 to 3.90)

1.02 (0.29 to 3.65)

0.00 (‐0.02 to 0.06)

TOFA + MTX

MTX or DMARD + non‐TNF

0.50 (0.09 to 2.55)

0.51 (0.10 to 2.42)

‐0.03 (‐0.09 to 0.05)

Random‐effects model

Residual deviance

9.006 vs. 8 data points

Deviance information criteria

42.328

Fixed‐effect model

Residual deviance

9.557 vs. 8 data points

Deviance information criteria

42.474

Note:

Total participants

1401

Total studies

4

2‐arm

4

DMARD: disease‐modifying anti‐rheumatic drug
MTX: methotrexate
TOFA: tofacitinib
TNF: tumor necrosis factor

Figuras y tablas -
Table 10. Withdrawals due to adverse events: analysis (MTX/other DMARD active comparator trials) for the type of medication: odds ratio (OR) for all treatment comparisons ‐ random‐effects model
Table 11. Serious adverse events: analysis (MTX/other DMARD active comparator trials) for the type of medication: odds ratio (OR) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

OR (95% CrI)

RR (95% CrI)

RD (95% Crl)

(MTX or DMARD) + non‐TNF

Comparator

0.84 (0.47 to 1.58)

0.85 (0.49 to 1.53)

‐0.01 (‐0.04 to 0.03)

(MTX or DMARD) + medications

0.54 (0.19 to 1.56)

0.56 (0.20 to 1.51)

‐0.03 (‐0.06 to 0.03)

TOFA + MTX

0.31 (0.07 to 1.29)

0.32 (0.07 to 1.27)

‐0.04 (‐0.08 to 0.02)

(MTX or DMARD) + medications

(MTX or DMARD) + non‐TNF

0.64 (0.19 to 2.13)

0.66 (0.20 to 2.02)

‐0.02 (‐0.07 to 0.05)

TOFA + MTX

0.36 (0.07 to 1.70)

0.38 (0.07 to 1.65)

‐0.03 (‐0.08 to 0.03)

TOFA + MTX

(MTX or DMARD) + medications

0.56 (0.09 to 3.37)

0.57 (0.09 to 3.21)

‐0.01 (‐0.08 to 0.05)

Random‐effects model

Residual deviance

8.969 vs. 10 data points

Deviance information criteria

56.677

Fixed‐effect model

Residual deviance

8.795 vs. 10 data points

Deviance information criteria

56.133

Note:

Total participants

1862

Total studies

5

2‐arm

5

DMARD: disease‐modifying anti‐rheumatic drug
MTX: methotrexate
TOFA: tofacitinib
TNF: tumor necrosis factor

Figuras y tablas -
Table 11. Serious adverse events: analysis (MTX/other DMARD active comparator trials) for the type of medication: odds ratio (OR) for all treatment comparisons ‐ random‐effects model
Table 12. Serious adverse events analysis (MTX/other DMARD active comparator trials) by dose: odds ratio (OR) for all treatment comparisons ‐ random‐effects model

Treatment

Reference

OR (95% CrI)

RR (95% CrI)

RD (95% Crl)

MTX SD

Comparator

0.80 (0.48 to 1.36)

0.82 (0.51 to 1.32)

‐0.01 (‐0.05 to 0.02)

MTX HD

0.48 (0.17 to 1.30)

0.50 (0.18 to 1.27)

‐0.04 (‐0.08 to 0.02)

MTX HD

MTX SD

0.60 (0.20 to 1.65)

0.62 (0.21 to 1.59)

‐0.02 (‐0.07 to 0.03)

Random‐effects model

Residual deviance

8.024 vs. 9 data points

Deviance information criteria

49.853

Fixed‐effect model

Residual deviance

7.837 vs. 9 data points

Deviance information criteria

49.137

Note:

Total participants

1463

Total studies

4

2‐arm

3

3‐arm

1

HD: high dose
MTX: methotrexate
SD: standard dose

Figuras y tablas -
Table 12. Serious adverse events analysis (MTX/other DMARD active comparator trials) by dose: odds ratio (OR) for all treatment comparisons ‐ random‐effects model