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. 2021 Apr 19;2021(4):CD011535. doi: 10.1002/14651858.CD011535.pub4

Gottlieb 2011.

Study characteristics
Methods RCT, placebo‐controlled, double‐blind
Date of study: June 2008 ‐ March 2009
Location: 33 centres in the USA
Participants Randomised: 209 participants (mean age 43.5 years, 145 male)
Inclusion criteria
  • Participants with moderate‐severe psoriasis (PGA ≥ 3, PASI ≥ 12, BSA ≥ 10), age ≥ 18 years


Exclusion criteria
  • Previous exposure to either etanercept or ABT‐874


Dropouts and withdrawals
  • 12/209 (5.7%): etanercept 7, placebo 5

  • Time and reasons:

    • Etanercept: AE (4), lost to follow‐up (1), protocol violation (1), Other (1)

    • Placebo: AE (0), lost to follow‐up (4), protocol violation (1)

Interventions Intervention
A. Etanercept (n = 141), SC, auto‐administered, 50 mg twice a week, 11 weeks
Control intervention
B. Placebo (n = 68), SC, auto‐administered, twice a week
Outcomes Assessments at 12 weeks
Primary outcomes of the trial
  • PASI 75/PGA 0/1


Secondary outcomes of the trial
At 4, 8, 12 weeks
  • PASI 50

  • PASI 75

  • PASI 90

  • DLQI

  • PGA

  • Safety

  • Patient global assessment of psoriasis

Notes Funding source, quote (Appendix 1): "Abbott Laboratories funded this study and participated in the study design, data collection, data management, data analysis and preparation of the manuscript. All of the authors had full access to the data and were involved in the analysis of data, development and revision of the manuscript, and decision to submit the manuscript for publication. The corresponding author takes responsibility for the integrity of the data and the accuracy of the data analysis..)"
Declarations of interest, quote (Appendix 1): "A.B.G. has been a consultant or served on an advisory board for Amgen, Centocor, Celgene, Bristol Myers Squibb, Beiersdorf, Abbott, TEVA, Actelion, UCB, Novo Nordisk, Immune Control, DermiPsor, Incyte, PureTech, Magen Biosciences, Cytokine Pharmasciences, Alnylam, Ono, Pfizer, Schering, Canfite, Schering, UCB, BIND Biosciences and Merck, and has received research/educational grants (paid to Tufts Medical Center) from Centocor, Amgen, Immune Control, Abbott, Novo Nordisk, UCB and Novartis. C.L. has been an investigator for Abbott, Allergan, Altana, Alza, Amgen, Astellas, Celgene, Centocor, Genentech, Bristol Myers, Eli Lilly, Galderma, Genzyme, Pfizer, Incyte, CombinatoRx, 3M Pharmaceuticals, Perrigo Israel Pharmaceutical, ScheringPlough, RTL, Novartis, Vitae and Wyeth; has served on an advisory board and has been a speaker for Abbott, Amgen and Centocor; and has been a consultant for Abbott, Amgen, Centocor and Pfizer. F.K. has been an investigator for Abbott, Centocor, Amgen, Wyeth, Novartis and Merck; and has served on an advisory board and has been a speaker for Abbott, Centocor, Amgen, Eisai, Astellas and Wyeth. S.M. has been an investigator for Abbott, Amgen, Celgene, Centocor, Graceway and Novo Nordisk; and has been a speaker for Abbott. M.O. and D.A.W. are employees of Abbott."
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Quote (p 653): "Patients were randomised..."
Comment: no description of the method used to guarantee random sequence generation
Allocation concealment (selection bias) Unclear risk Quote (p 653): "Patients were randomised"
Comment: no description of the method used to guarantee allocation concealment
Blinding of participants and personnel (performance bias)
All outcomes Low risk Quote (p 653): “Patients enrolled in the placebo arm received SC injections matching active treatment to maintain the blind. To maintain the blind, all patients received two SC injections at weeks 0 and 4 and one SC injection at week 8, consisting of either briakinumab or matching placebo, depending on the treatment arm. In addition, each patient also received two SC injections biweekly, 3 days apart, week 0 through week 11, consisting of either etanercept or matching placebo, depending on the treatment arm.”
Comment: probably done
Blinding of outcome assessment (detection bias)
All outcomes Low risk Quote (p 653): “Patients enrolled in the placebo arm received SC injections matching active treatment to maintain the blind. To maintain the blind, all patients received two SC injections at weeks 0 and 4 and one SC injection at week 8, consisting of either briakinumab or matching placebo, depending on the treatment arm. In addition, each patient also received two SC injections biweekly, 3 days apart, week 0 through week 11, consisting of either etanercept or matching placebo, depending on the treatment arm.”
Comment: probably done
Incomplete outcome data (attrition bias)
All outcomes Low risk Randomly assigned 209, analysed 209
Management of missing data:
Quote (p 654): “The primary efficacy analysis consisted of four comparisons performed in the intent‐to‐treat population (i.e. all randomised patients), …, Nonresponder imputation was used to handle missing data.”
Comment: done
Selective reporting (reporting bias) Low risk Comment: the protocol for the study was available on ClinicalTrials.gov (NCT00691964)
The prespecified outcomes and those mentioned in the Methods section appeared to have been reported