Mesh meta-analysis of the efficacy of original and biosimilar TNF-α inhibitors in the treatment of ankylosing spondylitis / 中华风湿病学杂志

ABSTRACT

Objective:In order to understand the difference of clinical efficacy between original TNF-α inhibitors (TNFi) and their biosimilars, Bayesian mesh Meta-analysis was compare Etanercept, Infliximab, Adalimumab with their biosimilars in the treatment of ankylosing spondylitis (AS).Methods:A systematic literature search was performed, using Ovid Biomedical, Embase, Cochrane Library, CNKI, Wanfang Database and Weipu Database (up to March 8, 2023 for all resources above), to search publications of randomized controlled trial (RCT) about all original and biosimilar TNFi for the treatment of AS in all language. Two reviewers independently identified the eligible trails, evaluated bias risk and extracted relevant data. Based on Bayesian network, data analysis of included studies was conducted using statistical software R3.6.1 and R Studio.Results:The results of the network meta-analysis showed that, no significant differences was observed among. Etanercept, Infliximab,Adalimumab, and their biosimilars for ASAS20 when Infliximab was compared with Etanercept [ OR (95% CI)=1.4 (0.54, 3.5)], placebo was compared with Etanercept [ OR (95% CI)=0.35 (0.17,0.67)], No significant differences were observed among Etanercept, Infliximab, Adalimumab, and their biosimilars for BASDAI, when Infliximab was compared with Ctanercept [ OR (95% CI)=-0.89 (-1.8, 0.081)], placebo was compared with Etanercept [ OR(95% CI)=1.7(0.86, 2.5)], No significant differences were observed among Etanercept, Infliximab, Adalimumab, and their biosimilars for BASFI, when Infliximab was compared with Etanercept [ OR(95% CI)=-0.46(-1.3, 0.47)], placebo was compared with Etanercept [ OR(95% CI)=1.6(0.8, 2.3)]. Conclusion:Etanercept, Infliximab, Adalimumab with their biosimilars are significantly superior to placebo and sulfasalazine in terms of ASAS20, BASDAI, BASFI, CRP, ESR. Limited evidence have shown that the efficacy of biological biosimilars are similar to that of their corresponding original drugs.