Ann Rheum Dis: The Efficacy of Rheumatoid Arthritis Medication: 2019 Updated Guidelines for the Treatment of Rheumatoid Arthritis

The study aims to inform the European Union against Rheumatoid (EULAR) guidelines for the treatment of rheumatoid arthritis (RA) updated in 2019conducted a systematic literature study (SLR) by retrieving articles published between 2016 and March 8, 2019 in the MEDLINE, Embase and Cochrane databases to analyze the efficacy of disease-improved anti-rheumatic drugs (DMARD) (conventional synthesis (cs) DMARD, biological (b) and biosimilar DMARD, targeted synthesis (ts) DMARD, or cortical hormone (GCRA)selected 234 abstracts for detailed evaluation, which was eventually included in 136These include the efficacy of bDMARDs vs placebo or other bDMARDs, the efficacy of Janus kinase (JAK) inhibitors (JAKi) in different patient populations, and the head-to-head efficacy of different bDMARDs vs JAKi vsother bDMARDsThe experiment of converting bDMARDs into other bDMARDs or tsDMARDs was evaluated, as well as the strategic experiments and reduction studies of bDMARDs, csDMARDs, and JAKiThe drugs assessed include Abassip, Adamu mono, ABT-122, Ballytini, Peihua Shejuda, SBI-087, CNTO6785, Dektinib, Inasip, non-lottini, Golimu mono, GCs, GS-9876, Guskudan, hydroxychloroquine, infyl, Flumit, mavrilimumab, methotrexate, Olozuma, otilimab, Pefeitinib, Litosidan, sarilumab, lyufia, sukina, sirukumab, taquemos, Tojuda, Tofadini, tregalizumab, Upatini, Usnuda, and vobarizumaThe efficacy of many bDMARDs and tsDMARDs has been demonstratedAfter TNFi treatment fails, switching to another tumor necrosis inhibitor (TNFi) or non-TNFi bDMARDs is effectivePatients who achieve long-term rigorous clinical remission can reduce DMARDsIn patients who are still active with the disease (including LDA patients), the risk of acute seizures increases during the reduction processBiosimilars are not inferior to their reference productsthe SLR provided the Working Group with basic information on the evidence of various treatment options, which would facilitate the updating of the EULAR RA treatment guidelines