title: Treatment modifying factors of biologics for psoriatic arthritis: a systematic review and Bayesian meta-regression.
abstract: OBJECTIVE
  The aim of this study was to explore factors that modify treatment effects of non-conventional biologics versus placebo in patients with psoriatic arthritis.
  
  
  METHODS
  A systematic literature review and meta-regression was conducted. The biologics included etanercept, infliximab, adalimumab, golimumab, certolizumab, ustekinumab, tocilizumab, anakinra, abatacept, rituximab, and secukinumab. Outcomes included American College of Rheumatology (ACR) 20 and 50, Psoriasis Area Severity Index (PASI) 75, and 36-Item Short Form Health Survey (SF-36) Physical and Mental Component Summaries (PCS and MCS).
  
  
  RESULTS
  Twelve RCTs were eligible for meta-regression. Treatment effects for ACR-20 at 12 weeks were higher in trials with longer disease durations (OR=2.94), and lower in trials enrolling older patients (OR=0.48), and those recently published (OR=0.49). Treatment effects for ACR-50 at 12 weeks were higher in trials with more males (OR=2.27), but lower in trials with high prior anti-TNF use (OR=0.28) and recently published trials (OR=0.37). For PASI-75, trials with more male patients (24 weeks: OR=2.56), and with higher swollen and tender joint counts (12 weeks: OR=8.33; 24 weeks: OR=14.44) showed higher treatment effects, and trials with high prior anti-TNF use had lower effects (OR=0.41). Treatment effects for SF-36 PCS at 24 weeks were higher in trials with longer psoriasis disease durations (OR=2.95) and PsA disease durations (OR=4.76), and those published earlier (OR=4.19).
  
  
  CONCLUSIONS
  Our analyses show that differences in baseline characteristics may explain some of the differences in response to biologics versus placebo across different trials. Accounting for these factors in future studies will likely be important.
authors.affiliation: Precision Health Economics, Vancouver, British Columbia, Canada. edruyts@redwoodoutcomes.com.
authors.forename: Eric
authors.initials: E
authors.lastname: Druyts
authors.affiliation: Novartis Pharmaceuticals, East Hanover, New Jersey, USA.
authors.forename: Jacqueline B
authors.initials: JB
authors.lastname: Palmer
authors.affiliation: Precision Health Economics, Vancouver, British Columbia, Canada.
authors.forename: Chakrapani
authors.initials: C
authors.lastname: Balijepalli
authors.affiliation: Precision Health Economics, Vancouver, British Columbia, Canada.
authors.forename: Keith
authors.initials: K
authors.lastname: Chan
authors.affiliation: Precision Health Economics, Vancouver, British Columbia, Canada.
authors.forename: Mir Sohail
authors.initials: MS
authors.lastname: Fazeli
authors.affiliation: Novartis Pharmaceuticals, East Hanover, New Jersey, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Herrera
authors.affiliation: Precision Health Economics, Vancouver, British Columbia, Canada.
authors.forename: Jeroen P
authors.initials: JP
authors.lastname: Jansen
authors.affiliation: Precision Health Economics, Vancouver, British Columbia, Canada.
authors.forename: Jay J H
authors.initials: JJH
authors.lastname: Park
authors.affiliation: Precision Health Economics, Vancouver, British Columbia, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Kanters
authors.affiliation: Rheumatology Section, Dallas VA Medical Center, Dallas; and Division of Rheumatic Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Andreas
authors.initials: A
authors.lastname: Reimold
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D001499:Bayes Theorem; D001688:Biological Products / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products