Evaluation of the efficacy and safety of sarilumab combination therapy in patients with rheumatoid arthritis with inadequate response to conventional disease-modifying antirheumatic drugs or tumour necrosis factor α inhibitors: systematic literature review and network meta-analyses.

To compare efficacy and safety of subcutaneous sarilumab 200 mg and 150 mg every 2 weeks plus conventional synthetic disease-modifying antirheumatic drugs (+csDMARDs) versus other targeted DMARDs+csDMARDs and placebo+csDMARDs, in inadequate responders to csDMARDs (csDMARD-IR) or tumour necrosis factor α inhibitors (TNFi-IR). Systematic literature review and network meta-analyses (NMA) conducted on 24 week efficacy and safety outcomes: Health Assessment Questionnaire Disability Index, modified total sharp score (mTSS, including 52 weeks), American College of Rheumatology (ACR) 20/50/70, European League Against Rheumatism Disease Activity Score 28-joint count erythrocyte sedimentation rate (DAS28)<2.6; serious infections/serious adverse events (including 52 weeks). 53 trials were selected for NMA. Results suggest that in csDMARD-IR and TNFi-IR (a smaller network), sarilumab+csDMARD had superior efficacy and similar safety versus placebo+csDMARDs and at least similar efficacy and safety versus other targeted DMARDs+csDMARDs.

Déclaration de conflit d'intérêts

Competing interests: EC has received research grants, consultancy and speaker fees from Amgen, Biogen, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Chugai Pharma, Eli Lilly, Janssen, Novimmune, Novartis, Pfizer, Regeneron, Roche, R-Pharm, Sanofi, Tonix and UCB. T-M-TH, LP, HvH and PC are employees of Sanofi and hold stock and/or stock options in the company. CP is a former employee of and current shareholder in Sanofi and current employee of Novartis. C-IC, AK and EM are employees of Regeneron Pharmaceuticals, Inc. and hold stock and/or stock options in the company. NF has received consulting fees from Sanofi, Novo Nordisk, Ipsen, Allergan, Takeda, Biogen, Abbvie, Lifecell.