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  • 1 Budapesti Corvinus Egyetem Egészség-gazdaságtani és Egészségügyi Technológiaelemzési Kutatóközpont Budapest Fővám tér 8. 1093
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A rheumatoid arthritis kezelésében jelentős változást hoztak a biológiai készítmények. Számos randomizált, kontrollált vizsgálatban értékelték hatásosságukat. Ezekben a vizsgálatokban a beválogatott betegek jellemzői különbözőek, és az adagolás módja is eltérő lehet. A vizsgálatokban placebokontrollt alkalmaztak, hiányzik a biológiai kezeléseket közvetlenül összehasonlító eredmény. Célkitűzés: A rheumatoid arthritisben alkalmazott biológiai készítmények hatásosságának indirekt összehasonlítása a randomizált klinikai vizsgálatok eredményei alapján. Annak számszerűsítése, hogy a rheumatoid arthritis súlyosságával szoros összefüggést mutató betegségfennállás és a funkcionális állapot változói hogyan befolyásolják a terápiás hatást. Módszer: A szerző elvégzi az adatok metaanalízisét és metaregresszió alkalmazásával megvizsgálja, hogy a betegséget leíró változók hogyan befolyásolják a megfigyelt hatást. Eredmények: A rendelkezésre álló irodalom kiterjedt, a metaanalízis eredményei 32 vizsgálatban követett 18 500 beteg adatain alapulnak. Az egyes gyógyszerek placebóhoz hasonlított esélyaránya monoterápiában 3,6–20,0 között, míg kombinációban 6,4–35,5 között változott. A biológiai kezelések páronkénti indirekt összehasonlítása szerint a relatív esélyarány 0,3–5,5 között volt. A betegség fennállásának hossza és a hozzáadott hagyományos bázisterápia pozitív, míg a betegség súlyossága negatív kapcsolatban volt a biológiai szerek relatív hatásosságával. Következtetések: Az elemzés szerint a biotechnológiai gyógyszerek hatásossága hasonló. Súlyosabb betegeknél a relatív hatás kisebb, hosszabb betegségfennállás nagyobb relatív hatással jár együtt. Orv. Hetil., 2011, 152, 919–928.

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