{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T14:37:25Z","timestamp":1769092645834,"version":"3.49.0"},"reference-count":46,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100009857","name":"Regeneron Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2018,12,3]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare efficacy and safety of subcutaneous sarilumab 200 mg and 150 mg every 2 weeks plus conventional synthetic disease-modifying antirheumatic drugs (+csDMARDs) versus other targeted DMARDs+csDMARDs and placebo+csDMARDs, in inadequate responders to csDMARDs (csDMARD-IR) or tumour necrosis factor \u03b1 inhibitors (TNFi-IR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Systematic literature review and network meta-analyses (NMA) conducted on 24 week efficacy and safety outcomes: Health Assessment Questionnaire Disability Index, modified total sharp score (mTSS, including 52 weeks), American College of Rheumatology (ACR) 20\/50\/70, European League Against Rheumatism Disease Activity Score 28-joint count erythrocyte sedimentation rate (DAS28)&lt;2.6; serious infections\/serious adverse events (including 52 weeks).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>53 trials were selected for NMA. <jats:italic>csDMARD-IR<\/jats:italic>: Sarilumab 200 mg+csDMARDs and 150 mg+csDMARDs were superior versus placebo+csDMARDs on all outcomes. Against most targeted DMARDs, sarilumab 200 mg showed no statistically significant differences, except superiority to baricitinib 2 mg, tofacitinib and certolizumab on 24 week mTSS. Sarilumab 150 mg was similar to all targeted DMARDs. <jats:italic>TNFi-IR:<\/jats:italic> Sarilumab 200 mg was similar to abatacept, golimumab, tocilizumab 4 mg and 8 mg\/kg intravenously and rituximab on ACR20\/50\/70, superior to baricitinib 2 mg on ACR50 and DAS28&lt;2.6\u2009and to abatacept, golimumab, tocilizumab 4 mg\/kg intravenously and rituximab on DAS28&lt;2.6. Sarilumab 150 mg was similar to targeted DMARDs but superior to baricitinib 2 mg and rituximab on DAS28&lt;2.6 and inferior to tocilizumab 8 mg on ACR20 and DAS28&lt;2.6. Serious adverse events, including serious infections, appeared similar for sarilumab versus comparators.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Results suggest that in csDMARD-IR and TNFi-IR (a smaller network), sarilumab+csDMARD had superior efficacy and similar safety versus placebo+csDMARDs and at least similar efficacy and safety versus other targeted DMARDs+csDMARDs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2018-000798","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T05:45:20Z","timestamp":1550555120000},"page":"e000798","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Evaluation of the efficacy and safety of sarilumab combination therapy in patients with rheumatoid arthritis with inadequate response to conventional disease-modifying antirheumatic drugs or tumour necrosis factor \u03b1 inhibitors: systematic literature review and network meta-analyses"],"prefix":"10.1136","volume":"5","author":[{"given":"Ernest","family":"Choy","sequence":"first","affiliation":[{"name":"Division of Infection and Immunity, Cardiff University, Cardiff, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Freemantle","sequence":"additional","affiliation":[{"name":"Institute for Clinical Trials and Methodology, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Proudfoot","sequence":"additional","affiliation":[{"name":"Formerly, Health Economics and Outcomes Research, Sanofi, Guildford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chieh-I","family":"Chen","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research, Regeneron Pharmaceuticals, Inc, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Pollissard","sequence":"additional","affiliation":[{"name":"Global Health Economics & Value Assessment, Sanofi France, Chilly-Mazarin, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Kuznik","sequence":"additional","affiliation":[{"name":"Health Economics and Outcomes Research, Regeneron Pharmaceuticals, Inc, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert","family":"Van Hoogstraten","sequence":"additional","affiliation":[{"name":"Global Medical Affairs, I&I, Sanofi, Bridgewater, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Mangan","sequence":"additional","affiliation":[{"name":"Medical Affairs, Regeneron Pharmaceuticals, Inc, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo","family":"Carita","sequence":"additional","affiliation":[{"name":"Global Health Economics & Value Assessment, Sanofi France, Chilly-Mazarin, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thi-Minh-Thao","family":"Huynh","sequence":"additional","affiliation":[{"name":"Real World Evidence & Clinical Outcome Generation, Sanofi France, Chilly-Mazarin, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,2,18]]},"reference":[{"key":"2025090312490069000_5.1.e000798.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.39480","article-title":"2015 American College of rheumatology guideline for the treatment of rheumatoid arthritis","volume":"68","author":"Singh","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"2025090312490069000_5.1.e000798.2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210715"},{"key":"2025090312490069000_5.1.e000798.3","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1002\/art.39093","article-title":"Sarilumab plus methotrexate in patients with active rheumatoid arthritis and inadequate response to methotrexate: results of a phase III study","volume":"67","author":"Genovese","year":"2015","journal-title":"Arthritis Rheumatol"},{"key":"2025090312490069000_5.1.e000798.4","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210310"},{"key":"2025090312490069000_5.1.e000798.5","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-016-1096-9"},{"key":"2025090312490069000_5.1.e000798.6","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/art.39944","article-title":"Sarilumab and nonbiologic disease-modifying antirheumatic drugs in patients with active rheumatoid arthritis and inadequate response or intolerance to tumor necrosis factor inhibitors","volume":"69","author":"Fleischmann","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"2025090312490069000_5.1.e000798.7","unstructured":"Epstein D . 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