Objective To evaluate the efficacy and safety of adalimumab for rheumatoid arthritis failing to respond to disease-modifying anti-rheumatic drugs (DMARDs).
Methods The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and Wanfang (from the date of their establishments to June 2010) were searched, and journals of relevant fields were retrieved to identify randomized controlled trials (RCTs). The data were analyzed by using RevMan 5.0 software.
Results Four RCTs were included, all of which were from abroad and with good methodological quality. The baseline data of each trial were comparable. Meta-analyses showed that there was a significant difference between the adalimumab and the placebo in terms of ACR20, ACR50, ACR70, tender joint count, swollen joint count, patient assessment of pain, patient global assessment of disease activity, doctor global assessment of disease activity, and disability index of the HAQ. There was no difference between the adalimumab and the placebo in terms of serious adverse events, intractable adverse events and serious infection.
Conclusion Adalimumab can treat rheumatoid arthritis failing to respond to DMARDs, but clinically the doctor should balance the benefit and the risk of the adalimumab.
Citation：
YANG Ximei,DOU Cunru,WEI Huaping. Adalimumab for Rheumatoid Arthritis Failing to Respond to Disease-Modifying Anti-Rheumatic Drugs: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2011, 11(1): 84-90. doi: 10.7507/1672-2531.20110015
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Copyright © the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved
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- 1. 郭子光, 熊曼琪, 徐要林, 等. 现代中医治疗学. 第1版. 四川科学技术出版社, 1995: 263-265.
- 2. 刘晓光, 张岩, 白艳春, 等. 类风湿性关节炎的治疗和护理体会. 现代医药卫生, 2007, 23(11): 1715-1716.
- 3. 亚太风湿病学会联盟. 不可忽视的风湿性关节炎病人开支[EB/OL]. (2009-9-30)[2010-07-23].http://fs.39.net/099/30/1015949.html.
- 4. 孙丽霞. 类风湿性关节炎治疗药——阿达木单抗(adalimumab). 世界临床药物, 2005, (4): 251-253.
- 5. Arnett FC, Edworthy SM, Bl och DA, et al. The American Rheumatis m Ass ociati on 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum, 1988, 31: 315-324 .
- 6. 陈灏珠. 实用内科学 (下册). 北京: 人民卫生出版社, 2001: 2318-2319 .
- 7. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
- 8. Review Manager (RevMan) [Computer program]. Version 5.0. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2008.
- 9. van de Putte LBA, Rau R, Breedveld FC, et al. Efficacy and safety of fully human anti-tumour necrosis factor a monoclonal antibody adalimumab (D2E7) in DMARD refractory patients with rheumatoid arthritis: a 12 week, phase II study. Ann Rheum Dis, 2003, 62: 1168-77.
- 10. van de Putte LBA, Atkins C, Malaise M, et al. Efficacy and safety of adalimumab as monotherapy in patients with rheumatoid arthritis for whom previous disease modifying antirheumatic drug treatment has failed. Ann Rheum Dis, 2004, 63(5): 508-516.
- 11. Lovell DJ, Ruperto N, Goodman S, et al. Adalimumab with or without methotrexate in juvenile rheumatoid arthritis. N Engl J Med, 2008, 359(8): 810-820.
- 12. Miyasaka N. Clinical investigation in highly disease-affected rheumatoid arthritis patients in Japan with adalimumab applying standard and general evaluation: the CHANGE study. Mod Rheumatol, 2008, 18(3): 252-262.
