Targeted immune modulators are used in the treatment of certain types of immunologic and inflammatory diseases, including rheumatoid arthritis (RA), juvenile rheumatoid arthritis (JRA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), plaque psoriasis, Crohn's disease, and ulcerative colitis (UC). These drugs work by selectively blocking mechanisms involved in the inflammatory and immune response. The purpose of this review is to help policy makers and clinicians make informed choices about the use of targeted immune modulators.

Contents

• Introduction
  • A. Targeted Immune Modulators (TIMs)
  • B. Rheumatoid Arthritis (RA)
  • C. Juvenile Rheumatoid Arthritis (JRA)
  • D. Ankylosing Spondylitis (AS)
  • E. Psoriatic Arthritis (PsA)
  • F. Crohn's Disease
  • G. Ulcerative Colitis (UC)
  • H. Plaque Psoriasis
  • I. Scope and Key Questions
• Methods
  • A. Literature Search
  • B. Study Selection
  • C. Data Abstraction
  • D. Quality Assessment
  • E. Data Synthesis
• Results
  • Key Question 1 How do included drugs compare in their effectiveness for alleviating symptoms and stabilizing the disease in patients with rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn's disease, and plaque psoriasis?
  • Key Question 2 What are the comparative incidence and severity of complications of included drugs?
  • Key Question 3 Do the included drugs differ in effectiveness or adverse events in different age, sex, or ethnic groups, or in patients taking other commonly prescribed drugs?
• Conclusions
  • Gaps in the Evidence
• References
• Appendixes
  • Appendix A. Search Strategy
  • Appendix B. Studies Already Included in Meta-analyses
  • Appendix C. Quality Criteria
  • Appendix D. Clinical Assessment Scales Commonly Used in Targeted Immune Modulators Trials
  • Appendix E. Study Characteristics, Pooled Relative Risks, and Forest Plots of Meta-analyses
  • Appendix F. Abstract-only Studies (Not Included)
  • Appendix G. Characteristics of Studies with Poor Internal Validity
  • Appendix H. Acknowledgements
• Evidence Tables
• List of Abbreviations

Oregon Evidence-based Practice Center, Oregon Health & Science University, Mark Helfand, MD, MPH, Director

The funding source, the Center for Evidence-based Policy, is supported by 17 organizations, including 15 state Medicaid programs. These organizations selected the topic and had input into the Key Questions for this review. The content and conclustions of this review are entirely determined by the Evidence-based Practice Center researchers. The authors of this report have no financial interest in any company that makes or distributes the products reviewed in this report.

Suggested citation:

Gartlehner, Hansen RA, Thieda P, Jonas B, Lohr KN, Carey T. (2005). Drug Class Review on Targeted Immune Modulators. http://www.ohsu.edu/drugeffectiveness

The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports.