How effective is anakinra in adults with rheumatoid arthritis (RA)?
There was significant variability among the included studies with the specific outcomes measured, limiting the power of the systematic review. The method of randomisation was not reported in any study, and a number did not report full blinding. Only 1 study described a true intention-to-treat analysis.
RA is the most common inflammatory arthritis in adults, affecting 0.5 to 1% of the population worldwide. Anakinra is an interleukin-1 receptor antagonist that is currently Federal Drug Authority-approved for moderate to severe RA that has been unresponsive to initial disease-modifying anti-rheumatic drug (DMARD) therapy. The primary efficacy outcome measure in the trials was the ACR 20 - a 20% improvement in tender and swollen joint counts, and the same level of improvement in 3 of the following 5 variables: patient/physician global assessments, pain scores, HAQ, score and laboratory acute phase reactants.