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Bridging disconnected networks of first and second lines of biologic therapies in rheumatoid arthritis with registry data : bayesian evidence synthesis with target trial emulation
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Bujkiewicz, Sylwia, Singh, Janharpreet, Wheaton, Lorna, Jenkins, David, Martina, Reynaldo, Hyrich, Kimme and Abrams, Keith R. (2022) Bridging disconnected networks of first and second lines of biologic therapies in rheumatoid arthritis with registry data : bayesian evidence synthesis with target trial emulation. Journal of Clinical Epidemiology, 150 . pp. 171-178. doi:10.1016/j.jclinepi.2022.06.011 ISSN 0895-4356.
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Official URL: https://doi.org/10.1016/j.jclinepi.2022.06.011
Abstract
Objectives
We aim to use real-world data in evidence synthesis to optimize an evidence base for the effectiveness of biologic therapies in rheumatoid arthritis to allow for evidence on first-line therapies to inform second-line effectiveness estimates.
Study Design and Setting
We use data from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis to supplement randomized controlled trials evidence obtained from the literature, by emulating target trials of treatment sequences to estimate treatment effects in each line of therapy. Treatment effects estimates from the target trials inform a bivariate network meta-analysis (NMA) of first-line and second-line treatments.
Results
Summary data were obtained from 21 trials of biologic therapies including two for second-line treatment and results from six emulated target trials of both treatment lines. Bivariate NMA resulted in a decrease in uncertainty around the effectiveness estimates of the second-line therapies, when compared to the results of univariate NMA, and allowed for predictions of treatment effects not evaluated in second-line randomized controlled trials.
Conclusion
Bivariate NMA provides effectiveness estimates for all treatments in first and second line, including predicted effects in second line where these estimates did not exist in the data. This novel methodology may have further applications; for example, for bridging networks of trials in children and adults. [Abstract copyright: Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.]
Item Type: | Journal Article | ||||||||||||||||||||||||
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Subjects: | R Medicine > R Medicine (General) | ||||||||||||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Statistics | ||||||||||||||||||||||||
SWORD Depositor: | Library Publications Router | ||||||||||||||||||||||||
Library of Congress Subject Headings (LCSH): | Evidence-based medicine, Meta-analysis, Rheumatoid arthritis -- Treatment | ||||||||||||||||||||||||
Journal or Publication Title: | Journal of Clinical Epidemiology | ||||||||||||||||||||||||
Publisher: | Elsevier Inc. | ||||||||||||||||||||||||
ISSN: | 0895-4356 | ||||||||||||||||||||||||
Official Date: | 1 October 2022 | ||||||||||||||||||||||||
Dates: |
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Volume: | 150 | ||||||||||||||||||||||||
Page Range: | pp. 171-178 | ||||||||||||||||||||||||
DOI: | 10.1016/j.jclinepi.2022.06.011 | ||||||||||||||||||||||||
Status: | Peer Reviewed | ||||||||||||||||||||||||
Publication Status: | Published | ||||||||||||||||||||||||
Reuse Statement (publisher, data, author rights): | ** From PubMed via Jisc Publications Router ** History: received 17-12-2021; revised 27-05-2022; accepted 20-06-2022. | ||||||||||||||||||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||||||||||||||||||
Date of first compliant deposit: | 1 September 2022 | ||||||||||||||||||||||||
Date of first compliant Open Access: | 1 September 2022 | ||||||||||||||||||||||||
RIOXX Funder/Project Grant: |
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