Table 2.
Rates and rate ratios for serious adverse events, serious infections and non-serious adverse events from network meta-analysis and pairwise meta-analysis
| Number of patients | Rate |
Rate ratio (PMA) |
I2 | Rate ratio (NMA) |
SUCRA | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Estimate | 95% LL | 95% UL | Estimate | 95% LL | 95% UL | Estimate | 95% LL | 95% UL | ||||
| Serious adverse events | ||||||||||||
| MTX + placebo | 3425 | 71 | 62.9 | 80.5 | 1 | 1 | 0.6 | |||||
| MTX + bDMARD | 3082 | 115.2 | 104.2 | 126.3 | 1.07 | 0.91 | 1.27 | 0.0% | 1.11 | 0.94 | 1.3 | 0.4 |
| bDMARD | 785 | 139.5 | 118.9 | 160.2 | 1.4 | 1.05 | 1.87 | 0.0% | 1.39 | 1.12 | 1.73 | 0.2 |
| tsDMARD | 1246 | 55.6 | 44.3 | 66.9 | 0.93 | 0.65 | 1.33 | 0.0% | 0.88 | 0.59 | 1.31 | 0.7 |
| MTX + tsDMARD | 215 | 87.3 | 56.8 | 117.8 | 0.72 | 0.33 | 1.57 | NA | 0.88 | 0.54 | 1.44 | 0.6 |
| SSZ | 34 | 88.2 | −11.6 | 188.1 | 3.6 | 0.19 | 69.75 | NA | 7.89 | 0.39 | 158.73 | 0.1 |
| MTX + SSZ | 36 | 13.9 | −24.6 | 52.4 | 0.49 | 0.01 | 24.5 | NA | 0.97 | 0.02 | 50.36 | 0.5 |
| MTX + Steroid | 174 | 11.2 | −0.5 | 22.9 | 0.41 | 0.08 | 2.1 | NA | 0.43 | 0.2 | 0.93 | 0.9 |
| Overall | 8997 | 69.8 | 64.9 | 74.8 | ||||||||
| Serious infections | ||||||||||||
| MTX + placebo | 3390 | 18.7 | 14.2 | 23.6 | 1 | 1 | 0.5 | |||||
| MTX + bDMARD | 3082 | 26.7 | 21.4 | 32.0 | 0.99 | 0.70 | 1.39 | 0.0% | 1.05 | 0.72 | 1.51 | 0.4 |
| bDMARD | 785 | 14.6 | 7.9 | 21.3 | 1.34 | 0.59 | 3.06 | 9.3% | 1.22 | 0.67 | 2.21 | 0.3 |
| tsDMARD | 1246 | 13.1 | 7.7 | 18.6 | 1.00 | 0.51 | 1.96 | 0.0% | 1.01 | 0.44 | 2.28 | 0.5 |
| MTX + tsDMARD | 215 | 26.8 | 9.9 | 43.6 | 0.53 | 0.14 | 1.97 | NA | 0.74 | 0.29 | 1.86 | 0.7 |
| SSZ | – | – | – | – | – | – | – | – | – | – | – | – |
| MTX + SSZ | – | – | – | – | – | – | – | – | – | – | – | – |
| MTX + Steroid | 57 | 12.6 | −12.1 | 37.4 | – | – | – | – | 0.53 | 0.04 | 6.60 | 0.7 |
| Overall | 8775 | 18.9 | 16.2 | 21.6 | ||||||||
| Non-serious adverse events | ||||||||||||
| MTX + placebo | 3061 | 937.9 | 903.3 | 972.4 | 1 | 1 | 0.5 | |||||
| MTX + bDMARD | 2638 | 1126.8 | 1088.6 | 1165.1 | 0.96 | 0.92 | 1.01 | 2.7% | 0.97 | 0.90 | 1.05 | 0.6 |
| bDMARD | 511 | 1142.2 | 1069.3 | 1215.2 | 0.93 | 0.85 | 1.01 | 0.0% | 0.96 | 0.85 | 1.08 | 0.7 |
| tsDMARD | 1246 | 1504.4 | 1445.8 | 1562.9 | 1.06 | 0.98 | 1.15 | 0.0% | 1.07 | 0.93 | 1.21 | 0.3 |
| MTX + tsDMARD | 215 | 947.1 | 846.7 | 1047.5 | 0.94 | 0.71 | 1.23 | NA | 0.98 | 0.81 | 1.20 | 0.6 |
| SSZ | 102 | 957.4 | 767.6 | 1147.3 | 1.04 | 0.74 | 1.47 | 0.0% | 1.04 | 0.70 | 1.54 | 0.4 |
| MTX + SSZ | 104 | 958.5 | 770.4 | 1146.7 | 1.04 | 0.74 | 1.47 | 0.0% | 1.05 | 0.71 | 1.54 | 0.4 |
| MTX + Steroid | 174 | 479.1 | 402.4 | 555.8 | 0.93 | 0.69 | 1.25 | NA | 0.97 | 0.76 | 1.24 | 0.6 |
| Overall | 8051 | 1048.2 | 1027.5 | 1068.9 | ||||||||
Pooled incidence rate per 1000 patient- years and rate ratios for serious adverse events, serious infections and non-serious adverse events across treatment strategies based on studies with direct comparisons. For strategies with zero events reported in one or both arms, a continuity correction of a fixed value (0.5) was added to each cell to create an event rate to allow odds ratio comparisons of the event rates between studies. Higher SUCRA values indicate a greater likelihood of a given treatment causing the least number of events, such that when the SUCRA value is 1, the treatment is the best, and when it is 0, it is the worst. I2 test reflects the the percentage of the variability in effect estimates that is due to heterogeneity. bDMARD: biologic DMARD; I2: I square statistics; NA: not applicable as only one study was available for that strategy; NMA: network meta-analysis; PMA: pairwise meta-analysis; SUCRA: Surface Under the Cumulative RAnking curve; tsDMARD: targeted synthetic DMARD.