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The need for comparative data in spondyloarthritis.

Ernest Choy1, Xenofon Baraliakos2, Frank Behrens3

  • 1CREATE Centre, Division of Infection and Immunity, Cardiff University School of Medicine, Wales, UK. ChoyEH@cardiff.ac.uk.

Arthritis Research & Therapy
|January 24, 2019
PubMed
Summary

Comparative studies for spondyloarthritis treatments are crucial but limited. Matching-adjusted indirect comparisons (MAICs) offer insights but face data challenges, necessitating methodological guidance for effective use.

Keywords:
Biological therapyClinical trialsPsoriatic arthritisRadiographySpondyloarthropathy

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Area of Science:

  • Rheumatology and Immunology
  • Clinical Trial Methodology
  • Health Economics

Background:

  • Spondyloarthritis encompasses inflammatory joint diseases like axial and peripheral arthritis, enthesitis, and dactylitis.
  • Biologic treatments and biosimilars are increasingly available for spondyloarthritis management.
  • Head-to-head studies comparing these treatments are scarce, hindering clinical and economic decision-making.

Purpose of the Study:

  • To review the utility and challenges of comparative effectiveness methods in spondyloarthritis.
  • To highlight the role of network meta-analyses and matching-adjusted indirect comparisons (MAICs).
  • To address the need for methodological guidance in comparative studies for spondyloarthritis.

Main Methods:

  • Discussion of network meta-analysis for common comparator trials.
  • Explanation of MAICs for heterogeneous populations and long-term comparisons.
  • Identification of limitations in current comparative study methodologies, including data availability.

Main Results:

  • MAICs are valuable for long-term comparisons beyond placebo phases, crucial for chronic conditions like spondyloarthritis.
  • Challenges in MAIC include poor availability of individual patient-level data.
  • Despite limitations, MAICs are increasingly accepted by health agencies.

Conclusions:

  • Conducting comparative studies in spondyloarthritis faces unique challenges like disease heterogeneity and lack of biomarkers.
  • Further methodological guidance is needed to optimize the use of MAICs in spondyloarthritis.
  • Robust comparative data are essential for informed clinical and economic decisions in spondyloarthritis treatment.