Figure 10 displays a forest plot for the network meta-analysis of studies reporting change from baseline in radiographic joint damage score. Four comparisons were used in this analysis. Study-level data used in this Figure are presented in Appendix C. This figure is described further in the KQ1 Results section “TNF Biologic Versus csDMARD Monotherapy”. For the combination of ADA plus MTX versus MTX monotherapy, the figure’s results were described as follows: “NWMA found higher ACR50 responses and less radiographic progression for ADA plus MTX combination therapy than for MTX (RR, 1.35; 95% CI, 1.15 to 1.59, and SMD, −0.99; 95% CI, −1.17 to −0.81, respectively)”. For the combination of CZP plus MTX versus MTX monotherapy, the figure’s results were described as follows: “In the NWMA, higher ACR50 response rates and less radiographic progression were also noted for CZP plus MTX combination therapy than MTX monotherapy (RR, 1.20; 95% CI, 1.04 to 1.38, and SMD, ‑0.38; 95% CI, −0.53 to −0.23, respectively)”. For the combination of ETN plus MTX versus MTX monotherapy, the figure’s results were described as follows: “In the NWMA, higher ACR50 response rates and less radiographic progression were also noted for MTX monotherapy (RR, 1.49; 95% CI, 1.27 to 1.74, and SMD, −0.81; 95% CI, −0.98 to −0.63, respectively)”. For the combination of IFX plus MTX versus MTX monotherapy, the figure’s results were described as follows: “In the NWMA, IFX plus MTX combination therapy also led to higher ACR50 response rates and less radiographic progression than MTX monotherapy (RR, 1.57; 95% CI, 1.30 to 1.88, and SMD, −0.42; 95% CI, −0.58 to −0.27, respectively)”.

Figure 10Forest plot for network meta-analysis of change from baseline in radiographic joint damage score: Comparison of TNF combined therapies with MTX only

95% CI = 95% confidence interval; MTX = methotrexate; SMD = standardized mean difference (mean difference divided by standard deviation); TNF = tumor necrosis factor; vs. = versus.

From: Results

Cover of Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update
Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update [Internet].
Comparative Effectiveness Review, No. 211.
Donahue KE, Gartlehner G, Schulman ER, et al.
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