Treatment comparison in rheumatoid arthritis: Head-to-head trials and innovative study designs

Ennio Giulio Favalli, Serena Bugatti, Martina Biggioggero, Roberto Caporali

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Over the last decades, the increasing knowledge in the area of rheumatoid arthritis has progressively expanded the arsenal of available drugs, especially with the introduction of novel targeted therapies such as biological disease modifying antirheumatic drugs (DMARDs). In this situation, rheumatologists are offered a wide range of treatment options, but on the other side the need for comparisons between available drugs becomes more and more crucial in order to better define the strategies for the choice and the optimal sequencing. Indirect comparisons or meta-analyses of data coming from different randomised controlled trials (RCTs) are not immune to conceptual and technical challenges and often provide inconsistent results. In this review we examine some of the possible evolutions of traditional RCTs, such as the inclusion of active comparators, aimed at individualising treatments in real-life conditions. Although head-to-head RCTs may be considered the best tool to directly compare the efficacy and safety of two different DMARDs, surprisingly only 20 studies with such design have been published in the last 25 years. Given the recent advent of the first RCTs truly comparing biological DMARDs, we also review the state of the art of head-to-head trials in RA.

Original languageEnglish
Article number831603
JournalBioMed Research International
Volume2014
DOIs
Publication statusPublished - 2014

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Antirheumatic Agents
Rheumatoid Arthritis
Randomized Controlled Trials
Arsenals
Pharmaceutical Preparations
Therapeutics
Meta-Analysis
Safety

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Medicine(all)

Cite this

Treatment comparison in rheumatoid arthritis : Head-to-head trials and innovative study designs. / Favalli, Ennio Giulio; Bugatti, Serena; Biggioggero, Martina; Caporali, Roberto.

In: BioMed Research International, Vol. 2014, 831603, 2014.

Research output: Contribution to journalArticle

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