Rheumatology Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain.
Semin Arthritis Rheum. 2013 Aug;43(1):9-17. doi: 10.1016/j.semarthrit.2012.11.007. Epub 2013 Jan 2.
To identify if rheumatoid factor (RF) is predictor of response to rituximab (RTX), abatacept (ABT), and tocilizumab (TCZ) in rheumatoid arthritis (RA).
Systematic review and meta-analysis of clinical trials and observational studies based on a sensitive search. Meta-regression was used to explore causes of heterogeneity. Unpublished data of clinical trials provided by the authors were also included.
The electronic search captured 3221 references and 422 meeting abstracts. By hand search, four additional articles were also identified. A total of 23 studies meet the purpose of the study and were included in the review. RF positivity at starting predicts better ACR20 [OR, 1.95 (1.24, 3.08)], ACR50 [OR, 5.38 (2.50, 11.60)] and EULAR response [OR, 3.52 (1.66, 7.45)] in 14 studies with RTX, and better ACR20 [OR, 1.51 (1.21, 1.90)] in 6 studies with TCZ. In 3 studies with ABT, no association was found between response and RF [OR 1.36 (0.97, 1.90)]. No asymmetries in the funnel plots or significant variables were found in the meta-regression.
In RA, RF positivity predicts better response to RTX and TCZ but not to ABT.
确定类风湿因子 (RF) 是否可预测类风湿关节炎 (RA) 患者对利妥昔单抗 (RTX)、阿巴西普 (ABT) 和托珠单抗 (TCZ) 的应答。
对基于敏感检索的临床试验和观察性研究进行系统评价和荟萃分析。采用元回归来探索异质性的原因。还纳入了作者提供的临床试验未发表数据。
电子检索捕获了 3221 条参考文献和 422 条会议摘要。通过手工检索，还确定了另外 4 篇文章。共有 23 项研究符合研究目的，并被纳入综述。14 项使用 RTX 的研究中，RF 阳性在治疗开始时预测 ACR20 应答更好[OR，1.95（1.24，3.08)]，ACR50 应答更好[OR，5.38（2.50，11.60)]，EULAR 应答更好[OR，3.52（1.66，7.45)]；6 项使用 TCZ 的研究中，RF 阳性预测 ACR20 应答更好[OR，1.51（1.21，1.90)]。3 项 ABT 研究中，应答与 RF 之间无相关性[OR 1.36（0.97，1.90)]。漏斗图无不对称性，元回归也未发现有显著变量。
在 RA 中，RF 阳性预测 RTX 和 TCZ 应答更好，但不预测 ABT 应答。
