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Meta-Analysis
. 2024 Oct 15;34(6):1079-1094.
doi: 10.1093/mr/roae049.

Systematic review and meta-analysis for the 2024 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis

Yoichi Nakayama  1 , Wataru Nagata  2 , Yoichi Takeuchi  3 , Sho Fukui  4 , Yuya Fujita  5 , Yohei Hosokawa  6 , Masanobu Ueno  5 , Kumiko Ono  7 , Shuji Sumitomo  8 , Yuya Tabuchi  1 , Yuichiro Nakanishi  9 , Shuntaro Saito  10 , Hiroko Ikeuchi  11 , Kazutaka Kawamori  12 , Hideaki Sofue  9 , Goro Doi  13 , Runa Minami  14 , Tomoya Hirota  15 , Kaoru Minegishi  16 , Keisuke Maeshima  17 , Ryo Motoyama  18 , Shohei Nakamura  18 , Shotaro Suzuki  19 , Norihiro Nishioka  11 , Takuma Tsuzuki Wada  20 , Akira Onishi  21 , Kenichi Nishimura  22 , Ryu Watanabe  23 , Ryo Yanai  12 , Takashi Kida  9 , Hiroki Nishiwaki  24 , Nobuyuki Yajima  12 , Yuko Kaneko  10 , Eiichi Tanaka  18 , Yutaka Kawahito  9 , Masayoshi Harigai  18
Affiliations
Free article
Meta-Analysis

Systematic review and meta-analysis for the 2024 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis

Yoichi Nakayama et al. Mod Rheumatol. .
Free article

Abstract

Objectives: The aim of this article is to update evidence on the efficacy and safety of disease-modifying antirheumatic drugs (DMARDs) and provide information to the taskforce for the 2024 update of the Japan College of Rheumatology clinical practice guidelines for the management of rheumatoid arthritis (RA).

Methods: We searched various databases for randomised controlled trials on RA published until June 2022, with no language restriction. For each of the 15 clinical questions, two independent reviewers screened the articles, evaluated the core outcomes, and performed meta-analyses.

Results: Subcutaneous injection of methotrexate (MTX) showed similar efficacy to oral MTX in MTX-naïve RA patients. Ozoralizumab combined with MTX improved drug efficacy compared to the placebo in RA patients with inadequate response (IR) to conventional synthetic DMARD (csDMARD). Rituximab with and without concomitant csDMARDs showed similar efficacy to other biological DMARDs (bDMARDs) in bDMARD-IR RA patients. Combined Janus kinase inhibitors and MTX achieved similar clinical responses and equal safety during a 4-year period compared to tumour necrosis factor inhibitors in MTX-IR RA patients. Biosimilars showed efficacy equivalent to that of the original bDMARDs in csDMARD-IR and bDMARD-IR RA patients.

Conclusions: This systematic review provides latest evidence for the 2024 update of the Japan College of Rheumatology clinical practice guidelines for RA management.

Keywords: Clinical practice guidelines; meta-analysis; ozoralizumab; rheumatoid arthritis; systematic review.

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