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Comparison of the efficacy and safety of olokizumab at different dosages in patients with active rheumatoid arthritis: a network meta-analysis of randomized controlled trials

Vergleich der Wirksamkeit und Sicherheit von Olokizumab in verschiedenen Dosierungen bei Patienten mit aktiver rheumatoider Arthritis: Netzwerk-Metaanalyse randomisierter kontrollierter Studien

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Abstract

Objective

This study aimed to assess the relative efficacy and safety of olokizumab at different dosages in patients with active rheumatoid arthritis (RA).

Methods

We performed a Bayesian network meta-analysis to combine direct and indirect evidence from randomized controlled trials (RCTs) to examine the efficacy and safety of olokizumab administered intravenously to RA patients at 64 mg/kg every 2 or 4 weeks (Q2 or Q4W).

Results

Five RCTs comprising 2609 patients met the inclusion criteria. Both olokizumab Q2 and Q4W treatments achieved a significant American College of Rheumatology 20% response (ACR20) compared with the placebo (odds ratio [OR] 3.21, 95% credible interval [CrI] 2.53–4.09; OR 3.05, 95% CrI 2.43–3.86). However, olokizumab Q2W was associated with the most favorable surface using the cumulative ranking curve (SUCRA) for the ACR20 response rate. The ranking probability based on the SUCRA indicated that olokizumab Q2W had the highest probability of being considered the best treatment option for achieving the ACR20 response rate, followed by olokizumab Q4W, adalimumab, and placebo. The ACR50 and 70 response rates showed a similar distribution pattern to the ACR20 response rate, except that olokizumab Q4W had a higher-ranking probability than olokizumab Q2W for ACR50. The SUCRA rating likelihood of adverse events (AEs) and withdrawal due to AEs showed that a placebo was likely to be the best intervention.

Conclusion

Both olokizumab Q2 and Q4W were efficacious and well-tolerated treatments for active RA.

Zusammenfassung

Ziel

Ziel der vorliegenden Studie war es, die relative Wirksamkeit und Sicherheit von Olokizumab in verschiedenen Dosierungen bei Patienten mit aktiver rheumatoider Arthritis (RA) zu untersuchen.

Methoden

Es wurde eine Bayes-Netzwerk-Metaanalyse zur Kombination direkter und indirekter Evidenz aus randomisierten kontrollierten Studien (RCT) durchgeführt, um die Wirksamkeit und Sicherheit von Olokizumab in der Dosierung von 64 mg/kg alle 2 Wochen (Q2W) oder alle 4 Wochen (Q4W) als i.v.-Gabe bei Patienten mit aktiver rheumatoider Arthritis (RA) zu untersuchen.

Ergebnisse

Die Einschlusskriterien wurden von 5 RCT mit 2609 Patienten erfüllt. Sowohl die Therapie mit Olokizumab Q2W als auch Q4W erzielte eine signifikante Therapieantwort von 20% gemäß American College of Rheumatology (ACR20) im Vergleich zu Placebo (Odds Ratio, OR: 3,21; 95%-Glaubwürdigkeitsintervall, „95% credible interval“, 95%-CrI: 2,53–4,09; OR 3,05; 95%-CrI: 2,43–3,86). Jedoch war Olokizumab Q2W mit der günstigsten Oberfläche bei Einsatz der kumulativen Rangfolgekurve (SUCRA, „surface using the cumulative ranking curve“) für die ACR20-Ansprechrate vergesellschaftet. Die Ranking-Wahrscheinlichkeit auf der Grundlage der SUCRA zeigte, dass Olokizumab Q2W die höchste Wahrscheinlichkeit aufwies, als beste Therapieoption zur Erzielung der ACR20-Ansprechrate zu gelten, danach folgten Olokizumab Q4W, Adalimumab und Placebo. Die ACR50- und ACR70-Ansprechraten wiesen ein ähnliches Verteilungsmuster wie die ACR20-Ansprechrate auf, außer, dass Olokizumab Q4W eine höhere Ranking-Wahrscheinlichkeit für ACR50 besaß als Olokizumab Q2W. Die SUCRA-Bewertungs-Wahrscheinlichkeit für unerwünschte Ereignisse (AE) und Therapieabbruch aufgrund von AE zeigte, dass ein Placebo am ehesten die beste Intervention darstellte.

Schlussfolgerung

Sowohl Olokizumab in der Dosierung Q2W als auch in der Dosierung Q4W war eine wirksame und gut verträgliche Behandlung der aktiven RA.

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Authors and Affiliations

  1. Department of Rheumatology, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, 02841, Seoul, Korea (Republic of)

    Young Ho Lee MD PhD & Gwan Gyu Song

Authors
  1. Young Ho Lee MD PhD
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  2. Gwan Gyu Song
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Correspondence to Young Ho Lee MD PhD.

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Conflict of interest

Y.H. Lee and G.G. Song declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Ulf Müller-Ladner, Bad Nauheim

Uwe Lange, Bad Nauheim

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Lee, Y.H., Song, G.G. Comparison of the efficacy and safety of olokizumab at different dosages in patients with active rheumatoid arthritis: a network meta-analysis of randomized controlled trials. Z Rheumatol 83 (Suppl 1), 107–114 (2024). https://doi.org/10.1007/s00393-023-01367-w

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