Abstract

CAMARGO-BARRIOS, Carmenza Beatriz; RIVAS-IBARGUEN, Jorge Eliécer  and  QUINTANA-LOPEZ, Gerardo. Biological therapy in early rheumatoid arthritis: Efficacy in disease remission. Rev.Colomb.Reumatol. [online]. 2017, vol.24, n.3, pp.164-176. ISSN 0121-8123.

Rheumatoid arthritis is a chronic, systemic inflammatory disease, with a world prevalence of around 1%. The course of the disease may be changed by using synthetic and/or biological disease-modifying antirheumatic drugs alone or in combination. This review assessed whether the use of biological agents in early rheumatoid arthritis can lead to disease remission.

Objective: To evaluate the efficacy of biological therapies in inducing remission in patients with early rheumatoid arthritis.

Methods: Type of study: systematic review of the literature. A systematic search of the literature was made in specialized electronic health databases: PubMed, Embase, Cochrane, LILACS, gray literature (doctoral theses, congresses, entity reports, unpublished works) and manual search (Secondary searches of the studies cited in the selected articles). Inclusion criteria: Patients older than 18 years with early rheumatoid arthritis (clinical course less than 12 months) according to criteria of the American College of Rheumatology / European League against Rheumatism (ACR 1987, ACR/ EULAR 2010), who received biological therapy Monotherapy or combined with other disease modifying antirheumatic drugs (DMARDs) and were included in randomized controlled trials.

Results: The systematic review of the literature identified 978 potentially relevant studies. Of the 86 that were chosen for a thorough evaluation, 68 articles were excluded. A qualitative and quantitative analysis of the remaining 18 studies was performed. A high risk of bias was identified in the studies evaluated and synthesis of the evidence did not show differences in the outcome of remission using biological therapy alone or combined with conventional DMARDs versus synthetic DMARDs (RR 1.08, 95% CI: 0.94-1.23).

Conclusions: There is no difference in the outcome of remission in patients with early rheumatoid arthritis receiving biological therapy versus patients treated with conventional disease modifying antirheumatic drugs.

Keywords : Early rheumatoid arthritis; Biological therapy; remission.

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