Beyond the Randomized Trial: A Network Meta-Analysis of DMARDs for Rheumatoid Arthritis

PhD defence by Louise Schow Guski

Assessment Committee

Professor Espen Solem, Department of Clinical Medicine, University of Copenhagen (Chairperson)
Professor Jesper Hallas, University of Southern Denmark
Professor Tuulikki Sokka-Isler, Central Hospital Central Finland & University of Eastern Finland

Supervisors

Professor Gesche Jürgens
Niels Albert Graudal
Associate Professor Stig Ejdrup Andersen

Department

Department of Clinical Medicine

Graduate Programme

Biostatistics and Bioinformatics

Place

Building: Uddannelsescentret, Room: Lassenauditoriet, Bispebjerg Hospital, Nielsine Nielsens Vej  12, 2400 København NV

Email address to gain access to the thesis: Louise@Guski.dk.
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Short description of the thesis

While the emergence of biologic treatments has expanded the therapeutic landscape, conventional synthetic disease-modifying drugs (csDMARDs) continue to play a central role in pharmacological treatment of rheumatoid arthritis, both as first-line drugs and as components in combination treatments. By the inclusion of 132 trials in one network, this project comprises the largest network meta-analysis on mono csDMARDs to date. These findings are supported by a smaller network focusing on radiographic progression. By incorporating previously used and potential csDMARDs, network connectiveness is strengthened around relevant drugs. However, this procedure requires an extensive effort and although complete, the network may also become overwhelming. Therefore, we also examined how network reduction would have influenced the results.