Efficacy and safety of adalimumab in hidradenitis suppurativa: A systematic review and meta-analysis of randomized controlled trials
Adalimumab is used as a first-line biologic agent in the management of moderate-to-severe hidradenitis suppurativa (HS). The objective of the present study was to evaluate the efficacy and safety of adalimumab in patients with moderate-to-severe HS. We performed a systematic review and meta-analysis...
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| Veröffentlicht in: | Medicine (Baltimore) 2021-06, Vol.100 (22), p.e26190-e26190 |
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| creator | Lu, Jing-Wun Huang, Yu-Wen Chen, Tai-Li |
| description | Adalimumab is used as a first-line biologic agent in the management of moderate-to-severe hidradenitis suppurativa (HS). The objective of the present study was to evaluate the efficacy and safety of adalimumab in patients with moderate-to-severe HS.
We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Pooled estimates, namely standardized mean difference (SMD) and relative risk (RR), were calculated using random-effect model with trial sequential analysis. Small study effects were examined using the Doi plot. Certainty of evidence (CoE) was assessed using "The Grading of Recommendations Assessment, Development, and Evaluation" approach, and number-needed-to-treat (NNT) was calculated.
Five randomized controlled trials, involving 1014 patients, were included. We performed subgroup analysis of adalimumab administered subcutaneously both weekly and every other week. Adalimumab administered weekly was associated with better clinical response achievement (RR 1.76, 95% confidence interval [95% CI] 1.35-2.29; trial sequential analysis TSA-adjusted CI 1.01-3.08; CoE: low; NNT = 5) and a significant improvement in modified Sartorius score (SMD = -0.45, 95% CI = -0.76 to -0.13; CoE: very low; NNT = 10) and dermatology life quality index (DLQI) (SMD -0.47, 95% CI -0.61 to -0.32; CoE: low; NNT = 10). Nevertheless, adalimumab administered every other week showed an improvement only in modified Sartorius score. The pooled RRs of adverse events in both groups revealed no statistical significance when compared with the placebo.
Adalimumab administered weekly resulted in not only better clinical responses than placebo but also significantly improved disease severity and quality of life of patients with moderate-to-severe HS. Our study provides supporting evidence to the current guidelines and aids decision-making in the application of adalimumab in HS management. |
| doi_str_mv | 10.1097/MD.0000000000026190 |
| format | Article |
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We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Pooled estimates, namely standardized mean difference (SMD) and relative risk (RR), were calculated using random-effect model with trial sequential analysis. Small study effects were examined using the Doi plot. Certainty of evidence (CoE) was assessed using "The Grading of Recommendations Assessment, Development, and Evaluation" approach, and number-needed-to-treat (NNT) was calculated.
Five randomized controlled trials, involving 1014 patients, were included. We performed subgroup analysis of adalimumab administered subcutaneously both weekly and every other week. Adalimumab administered weekly was associated with better clinical response achievement (RR 1.76, 95% confidence interval [95% CI] 1.35-2.29; trial sequential analysis TSA-adjusted CI 1.01-3.08; CoE: low; NNT = 5) and a significant improvement in modified Sartorius score (SMD = -0.45, 95% CI = -0.76 to -0.13; CoE: very low; NNT = 10) and dermatology life quality index (DLQI) (SMD -0.47, 95% CI -0.61 to -0.32; CoE: low; NNT = 10). Nevertheless, adalimumab administered every other week showed an improvement only in modified Sartorius score. The pooled RRs of adverse events in both groups revealed no statistical significance when compared with the placebo.
Adalimumab administered weekly resulted in not only better clinical responses than placebo but also significantly improved disease severity and quality of life of patients with moderate-to-severe HS. Our study provides supporting evidence to the current guidelines and aids decision-making in the application of adalimumab in HS management.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000026190</identifier><identifier>PMID: 34087885</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Adalimumab - administration & dosage ; Adalimumab - adverse effects ; Adalimumab - therapeutic use ; Adult ; Antibodies, Monoclonal, Humanized - administration & dosage ; Antibodies, Monoclonal, Humanized - adverse effects ; Antibodies, Monoclonal, Humanized - therapeutic use ; Case-Control Studies ; Hidradenitis Suppurativa - drug therapy ; Hidradenitis Suppurativa - psychology ; Humans ; Injections, Subcutaneous ; Middle Aged ; Placebos - administration & dosage ; Quality of Life ; Randomized Controlled Trials as Topic ; Severity of Illness Index ; Systematic Review and Meta-Analysis ; Treatment Outcome ; Tumor Necrosis Factor Inhibitors - therapeutic use ; Tumor Necrosis Factor-alpha - antagonists & inhibitors</subject><ispartof>Medicine (Baltimore), 2021-06, Vol.100 (22), p.e26190-e26190</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3558-a6b8f00f189135ca88a7d40bf2e39244565cb3afaf65266db71f42cfcfa9731c3</cites><orcidid>0000-0002-5761-8114</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183777/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183777/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34087885$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lu, Jing-Wun</creatorcontrib><creatorcontrib>Huang, Yu-Wen</creatorcontrib><creatorcontrib>Chen, Tai-Li</creatorcontrib><title>Efficacy and safety of adalimumab in hidradenitis suppurativa: A systematic review and meta-analysis of randomized controlled trials</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>Adalimumab is used as a first-line biologic agent in the management of moderate-to-severe hidradenitis suppurativa (HS). The objective of the present study was to evaluate the efficacy and safety of adalimumab in patients with moderate-to-severe HS.
We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Pooled estimates, namely standardized mean difference (SMD) and relative risk (RR), were calculated using random-effect model with trial sequential analysis. Small study effects were examined using the Doi plot. Certainty of evidence (CoE) was assessed using "The Grading of Recommendations Assessment, Development, and Evaluation" approach, and number-needed-to-treat (NNT) was calculated.
Five randomized controlled trials, involving 1014 patients, were included. We performed subgroup analysis of adalimumab administered subcutaneously both weekly and every other week. Adalimumab administered weekly was associated with better clinical response achievement (RR 1.76, 95% confidence interval [95% CI] 1.35-2.29; trial sequential analysis TSA-adjusted CI 1.01-3.08; CoE: low; NNT = 5) and a significant improvement in modified Sartorius score (SMD = -0.45, 95% CI = -0.76 to -0.13; CoE: very low; NNT = 10) and dermatology life quality index (DLQI) (SMD -0.47, 95% CI -0.61 to -0.32; CoE: low; NNT = 10). Nevertheless, adalimumab administered every other week showed an improvement only in modified Sartorius score. The pooled RRs of adverse events in both groups revealed no statistical significance when compared with the placebo.
Adalimumab administered weekly resulted in not only better clinical responses than placebo but also significantly improved disease severity and quality of life of patients with moderate-to-severe HS. Our study provides supporting evidence to the current guidelines and aids decision-making in the application of adalimumab in HS management.</description><subject>Adalimumab - administration & dosage</subject><subject>Adalimumab - adverse effects</subject><subject>Adalimumab - therapeutic use</subject><subject>Adult</subject><subject>Antibodies, Monoclonal, Humanized - administration & dosage</subject><subject>Antibodies, Monoclonal, Humanized - adverse effects</subject><subject>Antibodies, Monoclonal, Humanized - therapeutic use</subject><subject>Case-Control Studies</subject><subject>Hidradenitis Suppurativa - drug therapy</subject><subject>Hidradenitis Suppurativa - psychology</subject><subject>Humans</subject><subject>Injections, Subcutaneous</subject><subject>Middle Aged</subject><subject>Placebos - administration & dosage</subject><subject>Quality of Life</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Severity of Illness Index</subject><subject>Systematic Review and Meta-Analysis</subject><subject>Treatment Outcome</subject><subject>Tumor Necrosis Factor Inhibitors - therapeutic use</subject><subject>Tumor Necrosis Factor-alpha - antagonists & inhibitors</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkd1u1DAQhS0EotvCEyAhv0CK_-1wgVS1hSK14gauo4ljswYnWdnOrsI1D47pQvnxzdhn5nwe6SD0gpJzSlr96u7qnPw5TNGWPEIbKrlqZKvEY7Spqmx0q8UJOs35CyGUayaeohMuiNHGyA36fu19sGBXDNOAM3hXVjx7DAPEMC4j9DhMeBuGBIObQgkZ52W3WxKUsIfX-ALnNRc31qfFye2DO9yTRleggQnimqulAlNV5zF8cwO281TSHGO9lhQg5mfoia_FPf9Vz9Cnt9cfL2-a2w_v3l9e3DaWS2kaUL3xhHhqWsqlBWNAD4L0njneMiGkkrbn4MEryZQaek29YNZbD63m1PIz9ObI3S396Abr6h4Qu10KI6S1myF0_3amsO0-z_vOUMO11hXAjwCb5pyT8w9eSrqfoXR3V93_oVTXy7-_ffD8TqEOiOPAYY7Fpfw1LgeXuq2DWLb3PKlb1jDCKFFEkKYqyvAfzaqb1w</recordid><startdate>20210604</startdate><enddate>20210604</enddate><creator>Lu, Jing-Wun</creator><creator>Huang, Yu-Wen</creator><creator>Chen, Tai-Li</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5761-8114</orcidid></search><sort><creationdate>20210604</creationdate><title>Efficacy and safety of adalimumab in hidradenitis suppurativa: A systematic review and meta-analysis of randomized controlled trials</title><author>Lu, Jing-Wun ; Huang, Yu-Wen ; Chen, Tai-Li</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3558-a6b8f00f189135ca88a7d40bf2e39244565cb3afaf65266db71f42cfcfa9731c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adalimumab - administration & dosage</topic><topic>Adalimumab - adverse effects</topic><topic>Adalimumab - therapeutic use</topic><topic>Adult</topic><topic>Antibodies, Monoclonal, Humanized - administration & dosage</topic><topic>Antibodies, Monoclonal, Humanized - adverse effects</topic><topic>Antibodies, Monoclonal, Humanized - therapeutic use</topic><topic>Case-Control Studies</topic><topic>Hidradenitis Suppurativa - drug therapy</topic><topic>Hidradenitis Suppurativa - psychology</topic><topic>Humans</topic><topic>Injections, Subcutaneous</topic><topic>Middle Aged</topic><topic>Placebos - administration & dosage</topic><topic>Quality of Life</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Severity of Illness Index</topic><topic>Systematic Review and Meta-Analysis</topic><topic>Treatment Outcome</topic><topic>Tumor Necrosis Factor Inhibitors - therapeutic use</topic><topic>Tumor Necrosis Factor-alpha - antagonists & inhibitors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lu, Jing-Wun</creatorcontrib><creatorcontrib>Huang, Yu-Wen</creatorcontrib><creatorcontrib>Chen, Tai-Li</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lu, Jing-Wun</au><au>Huang, Yu-Wen</au><au>Chen, Tai-Li</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of adalimumab in hidradenitis suppurativa: A systematic review and meta-analysis of randomized controlled trials</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2021-06-04</date><risdate>2021</risdate><volume>100</volume><issue>22</issue><spage>e26190</spage><epage>e26190</epage><pages>e26190-e26190</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>Adalimumab is used as a first-line biologic agent in the management of moderate-to-severe hidradenitis suppurativa (HS). The objective of the present study was to evaluate the efficacy and safety of adalimumab in patients with moderate-to-severe HS.
We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Pooled estimates, namely standardized mean difference (SMD) and relative risk (RR), were calculated using random-effect model with trial sequential analysis. Small study effects were examined using the Doi plot. Certainty of evidence (CoE) was assessed using "The Grading of Recommendations Assessment, Development, and Evaluation" approach, and number-needed-to-treat (NNT) was calculated.
Five randomized controlled trials, involving 1014 patients, were included. We performed subgroup analysis of adalimumab administered subcutaneously both weekly and every other week. Adalimumab administered weekly was associated with better clinical response achievement (RR 1.76, 95% confidence interval [95% CI] 1.35-2.29; trial sequential analysis TSA-adjusted CI 1.01-3.08; CoE: low; NNT = 5) and a significant improvement in modified Sartorius score (SMD = -0.45, 95% CI = -0.76 to -0.13; CoE: very low; NNT = 10) and dermatology life quality index (DLQI) (SMD -0.47, 95% CI -0.61 to -0.32; CoE: low; NNT = 10). Nevertheless, adalimumab administered every other week showed an improvement only in modified Sartorius score. The pooled RRs of adverse events in both groups revealed no statistical significance when compared with the placebo.
Adalimumab administered weekly resulted in not only better clinical responses than placebo but also significantly improved disease severity and quality of life of patients with moderate-to-severe HS. Our study provides supporting evidence to the current guidelines and aids decision-making in the application of adalimumab in HS management.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>34087885</pmid><doi>10.1097/MD.0000000000026190</doi><orcidid>https://orcid.org/0000-0002-5761-8114</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adalimumab - administration & dosage Adalimumab - adverse effects Adalimumab - therapeutic use Adult Antibodies, Monoclonal, Humanized - administration & dosage Antibodies, Monoclonal, Humanized - adverse effects Antibodies, Monoclonal, Humanized - therapeutic use Case-Control Studies Hidradenitis Suppurativa - drug therapy Hidradenitis Suppurativa - psychology Humans Injections, Subcutaneous Middle Aged Placebos - administration & dosage Quality of Life Randomized Controlled Trials as Topic Severity of Illness Index Systematic Review and Meta-Analysis Treatment Outcome Tumor Necrosis Factor Inhibitors - therapeutic use Tumor Necrosis Factor-alpha - antagonists & inhibitors |
| title | Efficacy and safety of adalimumab in hidradenitis suppurativa: A systematic review and meta-analysis of randomized controlled trials |
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