Head-to-head trials in rheumatoid arthritis

Abstract

Head-to-head studies are important to select the optimal treatment in terms of efficacy and side effect profiles when several drugs are available. This article describes all studies comparing the use of disease-modifying antirheumatic drugs (DMARD) in rheumatoid arthritis (RA) in head-to-head studies or in which aDMARD was at least included in an active comparison arm. A total of 23studies comparing DMARDs were identified. These included comparisons of Janus kinase (JAK) inhibitors with methotrexate and with adalimumab as well as the oral surveillance study. There are already an exceptionally large number of head-to-head studies in RA, both for comparisons of efficacy and safety of DMARDs. Nevertheless, more such comparative studies are needed, for example to clarify whether adverse events of tofacitinib observed in the oral surveillance study are specific to the JAK1/JAK3 inhibitor or are aclass effect of all JAK inhibitors.