What is the best biological treatment for rheumatoid arthritis? A systematic review of effectiveness

Table 6 Meta-analysis of the outcomes for patients with anti-tumor necrosis factor therapeutic failure

Intervention	Outcomes	Studies (references)	n	Relative risk (95%CI)or other mesure	I2(%)	P value
RTX vs anti-TNF	EULAR good response	4 (35, 38, 40, 46)	1608	0.96 [0.60-1.54]	74	0.009
	EULAR moderate response	5 (29, 35, 38, 40, 46)	1706	1.02 [0.79-1.32]	66	0.02
	EULAR no response	3 (35, 38, 40)	1406	1.00 [0.53-1.89]	85	0.001
	DAS 28 reduction	6 (35, 36, 38, 40, 41, 46)	1584	0.42 [-0.65--0.20]	62	0.02
ETA vs control	EULAR good response	2 (14, 40)	173	2.11 [1.23-3.62]	0	0.48
	IFX		38	1.60 [0.63-4.09]
	RTX		135	2.42 [1.25-4.68]
	DAS 28 reduction	2 (34, 40)	152	0.15 [-0.65-0.95]	77	0.04
	RTX		113	-0.22 [-0.64-0.20]
	TOCI		39	0.60 [-0.05-1.25]

A value of I² > 40% indicates statistical heterogeneity between the studies. A value of P < 0.10 from the chi-square test indicates statistical heterogeneity between the studies. CI: Confidence interval; RTX: Rituximab; ETA: Etanercept; IFX: Infliximab; TOCI: Tocilizumab; EULAR: European League Against Rheumatism; DAS 28: Disease activity score.