Efficacy of RA treatments may be overestimated in clinical trials
medwireNews: Researchers have identified “substantial systematic differences” in the characteristics of patients with rheumatoid arthritis (RA) who have participated in randomized controlled trials (RCTs) compared with observational studies.
Therefore, the efficacy of treatments in clinical trials “may not reflect real-world effectiveness,” say Stephan Reichenbach (University of Bern, Switzerland) and study co-authors.
These findings are based on a systematic review of 51 RCTs and 76 observational studies of patients treated with rituximab, tocilizumab, or etanercept.
The team found that, on average, patients included in observational studies were 3.0 years older, had RA for 3.1 years longer, and were taking 1.6 more DMARDs than those included in RCTs.
“Randomized controlled trials enrolled RA patients with better prognostic factors, potentially overestimating the treatment effect,” write Reichenbach and colleagues in Rheumatology.
“Clearly, more work is required on how best to narrow the efficacy–effectiveness gap,” they conclude.
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