Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals
Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when trea...
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Gespeichert in:
| Autor*in: |
Pham, Phuong Anh [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2019 |
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| Schlagwörter: |
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| Anmerkung: |
© Springer-Verlag GmbH Germany, part of Springer Nature 2019 |
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| Übergeordnetes Werk: |
Enthalten in: Rheumatology international - Berlin : Springer, 1981, 39(2019), 4 vom: 25. Jan., Seite 605-618 |
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| Übergeordnetes Werk: |
volume:39 ; year:2019 ; number:4 ; day:25 ; month:01 ; pages:605-618 |
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| DOI / URN: |
10.1007/s00296-019-04244-5 |
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| Katalog-ID: |
SPR003876632 |
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| 245 | 1 | 0 | |a Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals |
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| 520 | |a Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. | ||
| 650 | 4 | |a Arthritis |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Psoriatic [MeSH] |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Anti-rheumatic agents* |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Meta-analysis [MeSH] |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Confidence intervals [MeSH] |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Werner, Ricardo Niklas |0 (orcid)0000-0003-3209-1392 |4 aut | |
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10.1007/s00296-019-04244-5 doi (DE-627)SPR003876632 (SPR)s00296-019-04244-5-e DE-627 ger DE-627 rakwb eng Pham, Phuong Anh verfasserin (orcid)0000-0002-3087-2825 aut Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. Arthritis (dpeaa)DE-He213 Psoriatic [MeSH] (dpeaa)DE-He213 Anti-rheumatic agents* (dpeaa)DE-He213 Meta-analysis [MeSH] (dpeaa)DE-He213 Confidence intervals [MeSH] (dpeaa)DE-He213 Dressler, Corinna (orcid)0000-0001-7075-2062 aut Eisert, Lisa (orcid)0000-0002-1664-1094 aut Nast, Alexander (orcid)0000-0003-3504-2203 aut Werner, Ricardo Niklas (orcid)0000-0003-3209-1392 aut Enthalten in Rheumatology international Berlin : Springer, 1981 39(2019), 4 vom: 25. Jan., Seite 605-618 (DE-627)265508320 (DE-600)1464208-6 1437-160X nnns volume:39 year:2019 number:4 day:25 month:01 pages:605-618 https://dx.doi.org/10.1007/s00296-019-04244-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2019 4 25 01 605-618 |
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10.1007/s00296-019-04244-5 doi (DE-627)SPR003876632 (SPR)s00296-019-04244-5-e DE-627 ger DE-627 rakwb eng Pham, Phuong Anh verfasserin (orcid)0000-0002-3087-2825 aut Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. Arthritis (dpeaa)DE-He213 Psoriatic [MeSH] (dpeaa)DE-He213 Anti-rheumatic agents* (dpeaa)DE-He213 Meta-analysis [MeSH] (dpeaa)DE-He213 Confidence intervals [MeSH] (dpeaa)DE-He213 Dressler, Corinna (orcid)0000-0001-7075-2062 aut Eisert, Lisa (orcid)0000-0002-1664-1094 aut Nast, Alexander (orcid)0000-0003-3504-2203 aut Werner, Ricardo Niklas (orcid)0000-0003-3209-1392 aut Enthalten in Rheumatology international Berlin : Springer, 1981 39(2019), 4 vom: 25. Jan., Seite 605-618 (DE-627)265508320 (DE-600)1464208-6 1437-160X nnns volume:39 year:2019 number:4 day:25 month:01 pages:605-618 https://dx.doi.org/10.1007/s00296-019-04244-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2019 4 25 01 605-618 |
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10.1007/s00296-019-04244-5 doi (DE-627)SPR003876632 (SPR)s00296-019-04244-5-e DE-627 ger DE-627 rakwb eng Pham, Phuong Anh verfasserin (orcid)0000-0002-3087-2825 aut Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. Arthritis (dpeaa)DE-He213 Psoriatic [MeSH] (dpeaa)DE-He213 Anti-rheumatic agents* (dpeaa)DE-He213 Meta-analysis [MeSH] (dpeaa)DE-He213 Confidence intervals [MeSH] (dpeaa)DE-He213 Dressler, Corinna (orcid)0000-0001-7075-2062 aut Eisert, Lisa (orcid)0000-0002-1664-1094 aut Nast, Alexander (orcid)0000-0003-3504-2203 aut Werner, Ricardo Niklas (orcid)0000-0003-3209-1392 aut Enthalten in Rheumatology international Berlin : Springer, 1981 39(2019), 4 vom: 25. Jan., Seite 605-618 (DE-627)265508320 (DE-600)1464208-6 1437-160X nnns volume:39 year:2019 number:4 day:25 month:01 pages:605-618 https://dx.doi.org/10.1007/s00296-019-04244-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2019 4 25 01 605-618 |
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10.1007/s00296-019-04244-5 doi (DE-627)SPR003876632 (SPR)s00296-019-04244-5-e DE-627 ger DE-627 rakwb eng Pham, Phuong Anh verfasserin (orcid)0000-0002-3087-2825 aut Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. Arthritis (dpeaa)DE-He213 Psoriatic [MeSH] (dpeaa)DE-He213 Anti-rheumatic agents* (dpeaa)DE-He213 Meta-analysis [MeSH] (dpeaa)DE-He213 Confidence intervals [MeSH] (dpeaa)DE-He213 Dressler, Corinna (orcid)0000-0001-7075-2062 aut Eisert, Lisa (orcid)0000-0002-1664-1094 aut Nast, Alexander (orcid)0000-0003-3504-2203 aut Werner, Ricardo Niklas (orcid)0000-0003-3209-1392 aut Enthalten in Rheumatology international Berlin : Springer, 1981 39(2019), 4 vom: 25. Jan., Seite 605-618 (DE-627)265508320 (DE-600)1464208-6 1437-160X nnns volume:39 year:2019 number:4 day:25 month:01 pages:605-618 https://dx.doi.org/10.1007/s00296-019-04244-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2019 4 25 01 605-618 |
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10.1007/s00296-019-04244-5 doi (DE-627)SPR003876632 (SPR)s00296-019-04244-5-e DE-627 ger DE-627 rakwb eng Pham, Phuong Anh verfasserin (orcid)0000-0002-3087-2825 aut Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. Arthritis (dpeaa)DE-He213 Psoriatic [MeSH] (dpeaa)DE-He213 Anti-rheumatic agents* (dpeaa)DE-He213 Meta-analysis [MeSH] (dpeaa)DE-He213 Confidence intervals [MeSH] (dpeaa)DE-He213 Dressler, Corinna (orcid)0000-0001-7075-2062 aut Eisert, Lisa (orcid)0000-0002-1664-1094 aut Nast, Alexander (orcid)0000-0003-3504-2203 aut Werner, Ricardo Niklas (orcid)0000-0003-3209-1392 aut Enthalten in Rheumatology international Berlin : Springer, 1981 39(2019), 4 vom: 25. Jan., Seite 605-618 (DE-627)265508320 (DE-600)1464208-6 1437-160X nnns volume:39 year:2019 number:4 day:25 month:01 pages:605-618 https://dx.doi.org/10.1007/s00296-019-04244-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 39 2019 4 25 01 605-618 |
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Pham, Phuong Anh @@aut@@ Dressler, Corinna @@aut@@ Eisert, Lisa @@aut@@ Nast, Alexander @@aut@@ Werner, Ricardo Niklas @@aut@@ |
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The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. 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| author |
Pham, Phuong Anh |
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Pham, Phuong Anh misc Arthritis misc Psoriatic [MeSH] misc Anti-rheumatic agents* misc Meta-analysis [MeSH] misc Confidence intervals [MeSH] Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals |
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Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals Arthritis (dpeaa)DE-He213 Psoriatic [MeSH] (dpeaa)DE-He213 Anti-rheumatic agents* (dpeaa)DE-He213 Meta-analysis [MeSH] (dpeaa)DE-He213 Confidence intervals [MeSH] (dpeaa)DE-He213 |
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misc Arthritis misc Psoriatic [MeSH] misc Anti-rheumatic agents* misc Meta-analysis [MeSH] misc Confidence intervals [MeSH] |
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misc Arthritis misc Psoriatic [MeSH] misc Anti-rheumatic agents* misc Meta-analysis [MeSH] misc Confidence intervals [MeSH] |
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Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals |
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Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals |
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Pham, Phuong Anh Dressler, Corinna Eisert, Lisa Nast, Alexander Werner, Ricardo Niklas |
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Pham, Phuong Anh |
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10.1007/s00296-019-04244-5 |
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(ORCID)0000-0002-3087-2825 (ORCID)0000-0001-7075-2062 (ORCID)0000-0002-1664-1094 (ORCID)0000-0003-3504-2203 (ORCID)0000-0003-3209-1392 |
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time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals |
| title_auth |
Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals |
| abstract |
Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. © Springer-Verlag GmbH Germany, part of Springer Nature 2019 |
| abstractGer |
Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. © Springer-Verlag GmbH Germany, part of Springer Nature 2019 |
| abstract_unstemmed |
Abstract Psoriatic arthritis (PsA) is associated with progressive joint destruction and reduced quality of life. The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. For PASI75, ixekizumab is faster than adalimumab. © Springer-Verlag GmbH Germany, part of Springer Nature 2019 |
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Time until onset of action when treating psoriatic arthritis: meta-analysis and novel approach of generating confidence intervals |
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https://dx.doi.org/10.1007/s00296-019-04244-5 |
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Dressler, Corinna Eisert, Lisa Nast, Alexander Werner, Ricardo Niklas |
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Dressler, Corinna Eisert, Lisa Nast, Alexander Werner, Ricardo Niklas |
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| doi_str |
10.1007/s00296-019-04244-5 |
| up_date |
2024-07-03T22:14:51.258Z |
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The time until a drug treatment starts to show an effect (TOA) is important for preventing joint destruction. The objective was to assess the time until onset of action of drugs when treating PsA. A systematic review of PsA drug trials was performed. Outcomes were: time until 25% of patients (TOA) reached (1) ≥ 20%, (2) ≥ 50% improvement in modified American College of Rheumatology response criteria (ACR), (3) ≥ 75% reduction in Psoriasis Area and Severity Index (PASI75). 95% confidence intervals were calculated extracting data from graphs using a novel method. Meta-analysis was conducted. Two head-to-head trials show no difference between ixekizumab and adalimumab or adalimumab and tofacitinib for TOA-ACR outcomes. For PASI75, ixekizumab had a faster onset than adalimumab. Infliximab plus MTX was faster than MTX alone. Pooled results from 32 study arms for TOA-ACR20 (week [95% CI]) are: < 2 weeks: infliximab (1.18 [0.72–1.65]), ixekizumab (1.04 [0.80–1.28]), tofacitinib (10 mg 1.56 [1.14–1.98]); ≤ 4 weeks: adalimumab (1.95 [1.35–2.55]), secukinumab (75 mg 1.89 [0.16–3.62], 150 mg 2.13 [1.34–2.91], 300 mg 2.26 [1.75–2.76]), tofacitinib (5 mg 2.20 [1.41–2.99]); 4 + weeks: apremilast, ustekinumab. For TOA-ACR50, all pooled point estimates are > 4 weeks. For TOA-PASI75, the range is between 2.24 [1.65–2.84] for ixekizumab and 6.03 [3.76–8.29] for adalimumab. Indirect, mixed comparison suggest a faster onset of infliximab, ixekizumab and tofacitinib compared to apremilast, methotrexate and ustekinumab for ACR20, not ACR50. 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| score |
7.3973074 |