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Drug class review : targeted immune modulators : final update 3 report

Thaler, Kylie J
Oregon Health & Science University
Drug Effectiveness Review Project
Research Triangle Institute-University of North Carolina Evidence-based Practice Center
Drug class review : targeted immune modulators : final update 3 reportĀ [electronic resource] / Kylie J. Thaler ... [et al.].
Other Title(s):
Targeted immune modulators
Drug class reviews
Country of Publication:
United States
Portland, OR : Oregon Health & Science University, c2012.
1 online resource (1 PDF file (195 p.)).
Electronic Links:
PURPOSE: We systematically compared the efficacy, effectiveness, and safety (adverse events) of abatacept, adalimumab, alefacept, anakinra, certolizumab pegol, etanercept, golimumab, infliximab, natalizumab, rituximab, tocilizumab, and ustekinumab in patients with rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn's disease, ulcerative colitis, and plaque psoriasis. DATA SOURCES: To identify published studies, we searched PubMed, EMBASE, CINAHL, Centre for Reviews and Dissemination, The Cochrane Library, and International Pharmaceutical Abstracts from 2009 (January) to 2011 (October). We also searched the US Food and Drug Administration Center for Drug Evaluation and Research website for additional unpublished data, requested dossiers of information from pharmaceutical manufacturers, and retrieved relevant citations from reference lists of included studies. REVIEW METHODS: Study selection, data abstraction, validity assessment, grading the strength of the evidence, and data synthesis were all carried out according to our standard review methods. RESULTS AND CONCLUSION: Overall, targeted immune modulators are highly effective medications for the treatment of rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn's disease, ulcerative colitis, and plaque psoriasis that substantially improve the burden of disease and are generally safe for short-term treatment. For rheumatoid arthritis, low-and moderate-strength evidence indicated that some targeted immune modulators are more efficacious than others. These results were based on three head-to-head trials, several large observational studies, and indirect comparisons of placebo-controlled trials. The evidence is currently insufficient to reliably determine the comparative effectiveness for other indications and in subgroups. Low-strength evidence indicated that serious infections are less common with abatacept than the other drugs and that the rate of adverse events is greater with infliximab than adalimumab or etanercept. Likewise, more patients receiving infliximab withdrew due to adverse events than abatacept, adalimumab, etanercept, and golimumab. Infusion or allergic reactions contributed to the difference in risk.
Drug Evaluation
Immunoconjugates/therapeutic use
Immunologic Factors/therapeutic use*
Publication Type(s):
"March 2012."
Includes bibliographical references.
Funding: The Drug Effectiveness Review Project, composed of 12 organizations including 11 State Medicaid agencies, and the Canadian Agency for Drugs and Technology in Health commissioned and funded for this report. These organizations selected the topic of the report and had input into its Key Questions. The content and conclusions of the report were entirely determined by the Evidence-based Practice Center researchers. The authors of this report have no financial interest in any company that makes or distributes the products reviewed in this report.
Description based on online resource; title from PDF title page (viewed Mar. 20, 2013).
101601231 [Electronic Resource]

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