Role of biological agents in treatment of rheumatoid arthritis

Law, Shing T.; Taylor, Peter

doi:10.1016/j.phrs.2019.104497

Cited by 42 publications

(24 citation statements)

References 72 publications

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“…Even though some of these drugs will at some point be off patent and available in generic form at reduced cost, they may only be used in patients after failure of Disease‐modifying antirheumatic drugs (DMARDs), because they still are very expensive compared with conventional drugs, such as methotrexate. Despite the increasing number of randomized trials assessing drugs for psoriasis in recent years, the total number of studies and patients remains low compared to rheumatoid arthritis [76]. Limited by the relatively small number of studies and with no available head‐to‐head comparisons in the literature, multiple‐treatments meta‐analysis can help identify the best treatment.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy and safety of biologics in moderate to severe plaque psoriasis: a multiple‐treatments meta‐analysis

Gao

Deng

et al. 2020

J Deutsche Derma Gesell

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Objective: To compare the efficacy and safety of biologics for patients with moderate to severe plaque psoriasis. Methods: We systematically reviewed 60 randomized controlled trials (34,020 participants), which compared 14 biological drugs for treatment of moderate to severe plaque psoriasis. The main assessment criteria were ≥ 90 % reductions in Psoriasis Area and Severity Index (PASI 90) and the number of patients who reported treatment-emergent adverse events (AEs). Secondary criteria were ≥ 75 % reductions in Psoriasis Area and Severity Index (PASI 75), Physician's Global Assessment 0/1 (PGA 0/1) and infections. Results: This network meta-analysis showed that biologics were significantly more effective than placebo. Ixekizumab, risankizumab, and bimekizumab were among the most effective treatments, and tildrakizumab, guselkumab and risankizumab were better than the other drugs with respect to safety. Risankizumab and guselkumab performed relatively stable with respect to both efficacy and safety. At the class level, blockers of interleukin (IL)-17A showed favorable efficacy while inhibitors of the p19 subunit of IL-23 were best tolerated of all efficient biologics. Conclusions: Ixekizumab was the most effective biologic in PASI 90, while IL-23p19 inhibitors, risankizumab and guselkumab performed relatively stable with respect to efficacy and safety.

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Section: Discussionmentioning

confidence: 99%

Comparative efficacy and safety of biologics in moderate to severe plaque psoriasis: a multiple‐treatments meta‐analysis

Gao

Deng

et al. 2020

J Deutsche Derma Gesell

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“…Understanding the mechanisms involved in RA pathogenesis has led in large part to the clinical development of therapeutic drugs targeting specific cells and molecules. In fact, the most successful therapeutic strategy in this disease include disease-modifyinganti-rheumatic drugs (DMARDs), such as methotrexate and cytokine-directed therapies including inhibitors of tumor necrosis factor (TNF) and interleukin (IL)-6 [7,8]. However, these drugs are effective only in a fraction of patients and have other limitations including high cost, the requirement of parenteral administration and important side effects.…”

Section: Introductionmentioning

confidence: 99%

A New Peracetylated Oleuropein Derivative Ameliorates Joint Inflammation and Destruction in a Murine Collagen-Induced Arthritis Model via Activation of the Nrf-2/Ho-1 Antioxidant Pathway and Suppression of MAPKs and NF-κB Activation

et al. 2021

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Oleuropein (OL), an olive tree secoiridoid and its peracetylated derivate (Per-OL) have exhibited several beneficial effects on LPS-stimulated macrophages and murine experimental systemic lupus erythematosus (SLE). This study was designed to evaluate dietary Per-OL in comparison with OL supplementation effects on collagen-induced arthritis (CIA) murine model. Three-weeks-old DBA-1/J male mice were fed from weaning with a standard commercial diet or experimental enriched-diets in 0.05 % (w/w) OL, 0.05% and 0.025% Per-OL. After six weeks of pre-treatment, arthritis was induced by bovine collagen type II by tail base injection (day 0) and on day 21, mice received a booster injection. Mice were sacrificed 42 days after the first immunization. Both Per-OL and OL diets significantly prevented histological damage and arthritic score development, although no statistically significant differences were observed between both compounds. Also, serum collagen oligomeric matrix protein (COMP), metalloprotease (MMP)-3 and pro-inflammatory cytokines levels were ameliorated in paws from secoiridoids fed animals. Mitogen-activated protein kinases (MAPK)s and nuclear transcription factor-kappa-B (NF-κB) activations were drastically down-regulated whereas nuclear factor E2-related factor 2 (Nrf2) and heme-oxygenase-1 (HO-1) protein expressions were up-regulated in those mice fed with OL and Per-OL diets. We conclude that both Per-OL and its parent compound, OL, supplements might provide a basis for developing a new dietary strategy for the prevention of rheumatoid arthritis.

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“…Biological agents have revolutionised treatment across a range of immune-and inflammatorymediated diseases [1][2][3][4], and the efficacy and manageable side-effect profiles of these agents have led to them being recommended in treatment guidelines [5][6][7][8][9]. However, the use of intravenous (IV) infusions for these biologics involves invasive procedures that can be inconvenient for both patients and healthcare professionals alike [10].…”

Section: Introductionmentioning

confidence: 99%

Understanding and Minimising Injection-Site Pain Following Subcutaneous Administration of Biologics: A Narrative Review

et al. 2020

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Injection-site pain (ISP) is a subjective side effect that is commonly reported with the subcutaneous administration of biological agents, yet it may only be a concern to some. Multiple factors related to the product formulation, such as pH, volume and excipients, and/or to the injection process have the potential to contribute to ISP, while patient-related factors, such as low body weight, gender and age, can make an individual more susceptible to experiencing ISP. While total elimination of ISP remains unlikely with any subcutaneously administered agent, it can be minimised by helping the patient to develop a confident and competent injection technique via robust and effective training. Careful management of patient expectations along with open discussion regarding the potential risk of ISP may serve to minimise treatment-related anxieties and, importantly, allow the patient to remain in control of his/her treatment. Other interventions to help minimise ISP include psychological interventions, allowing biologics to reach room temperature prior to injection, using the most suitable injection device for the individual patient and selecting an alternative drug formulation, when available. Productive patient–physician communication remains important in order to support and optimise treatment experience and adherence, while also providing the opportunity for patients to discuss any ISP-related issues.

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Role of biological agents in treatment of rheumatoid arthritis

Cited by 42 publications

References 72 publications

Comparative efficacy and safety of biologics in moderate to severe plaque psoriasis: a multiple‐treatments meta‐analysis

Comparative efficacy and safety of biologics in moderate to severe plaque psoriasis: a multiple‐treatments meta‐analysis

A New Peracetylated Oleuropein Derivative Ameliorates Joint Inflammation and Destruction in a Murine Collagen-Induced Arthritis Model via Activation of the Nrf-2/Ho-1 Antioxidant Pathway and Suppression of MAPKs and NF-κB Activation

Understanding and Minimising Injection-Site Pain Following Subcutaneous Administration of Biologics: A Narrative Review

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