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DOSAGE AND DURATION OF ETANERCEPT THERAPY FOR ANKYLOSING SPONDYLITIS: A META-ANALYSIS

Published online by Cambridge University Press:  24 April 2017

Heeyoung Lee ,
Younjoo Jung ,
Seungyeon Song ,
Jihyung Lee ,
Hyunjun Shim ,
Wonku Kang  and
Eunyoung Kim
Heeyoung Lee
Affiliation:
Evidence-based Research Lab, Division of Clinical Pharmacotherapy
Younjoo Jung
Affiliation:
Evidence-based Research Lab, Division of Clinical Pharmacotherapy Division of Medication information Services, Veterans Hospital
Seungyeon Song
Affiliation:
Evidence-based Research Lab, Division of Clinical Pharmacotherapy
Jihyung Lee
Affiliation:
Evidence-based Research Lab, Division of Clinical Pharmacotherapy
Hyunjun Shim
Affiliation:
The Graduate School Pharmaceutical Management, Chung-Ang University
Wonku Kang
Affiliation:
College of Pharmacy, Chung-Ang University
Eunyoung Kim
Affiliation:
Evidence-based Research Lab, Division of Clinical Pharmacotherapy The Graduate School Pharmaceutical Management, Chung-Ang University College of Pharmacy, Chung-Ang Universityeykimjcb777@cau.ac.kr
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Abstract

Objectives: We conducted a meta-analysis of recently published randomized controlled trials (RCTs) to identify the most effective and safe etanercept dosing regimen and duration of therapy for the treatment of patients with ankylosing spondylitis (AS).

Methods: We systematically reviewed PubMed, Embase, Cochrane Library, and Web of Science databases for RCTs. The proportion of patients attaining 20 percent improvement (according to the Spondyloarthritis International Society response criteria [ASAS 20]) was evaluated as a primary outcome. Secondary outcomes included 50 percent increase in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI 50) used for evaluating efficacy, as well as the BASDAI/Bath Ankylosing Spondylitis Functional Index (BASFI) scores and adverse events.

Results: ASAS 20 indicated that the efficacy of etanercept did not differ amongst dosing regimens (25 mg twice-weekly versus 50 mg once-weekly: relative risk [RR], 2.18, 95 percent confidence interval [CI], 1.78–2.67 versus RR, 2.00, 95 percent CI, 1.70–2.37). The ASAS 20 reported subgroup differences among treatment durations of less than 12 weeks (RR, 2.70; 95 percent CI, 2.09–3.49); 12 weeks (RR, 1.74; 95 percent CI, 1.37–2.22); and more than 12 weeks (RR, 2.56; 95 percent CI, 1.88–3.48). Other outcomes included BASDAI, BASDAI 50, and BASFI. Drug safety differed according to the treatment regimen and duration.

Conclusion: Our meta-analysis found that there was no significant efficacy difference between 50 mg once-weekly and 25 mg twice-weekly dosing for the treatment of AS, and a dosing duration of less than 12 weeks was more effective for treating AS patients.

Keywords

Meta-analysisEtanerceptAnkylosing spondylitisDosing regimenDuration of therapy
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 1 , 2017 , pp. 69 - 75
Copyright
Copyright © Cambridge University Press 2017 

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