Chris Cameron1, Brian Hutton2,3, Cheryl Druchok1, Sean McElligott4, Sandhya Nair5, Agata Schubert6, Aaron Situ1, Abhishek Varu1, Reggie Villacorta4. 1. Cornerstone Research Group, Inc., Burlington, Ontario, Canada. 2. Clinical Epidermology Program, Ottawa Hospital Research Institute, Ottawa, Canada. 3. School of Epidemiology, Public Health & Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada. 4. Janssen Research & Development, LLC, Spring House, PA, 19477, USA. 5. Janssen Pharmaceutica NV, Turnhoutseweg 30, 2340 Beerse, Belgium. 6. Janssen-Cilag, Warsaw, Poland.
Abstract
AIM: The importance of adjusting for cross-study heterogeneity when conducting network meta-analyses (NMAs) was demonstrated using a case study of biologic therapies for moderate-to-severe plaque psoriasis. METHODS: Bayesian NMAs were conducted for Psoriasis Area and Severity Index 90 response. Several covariates were considered to account for cross-trial differences: baseline risk (i.e., placebo response), prior biologic use, body weight, psoriasis duration, age, race and baseline Psoriasis Area and Severity Index score. Model fit was evaluated. RESULTS: The baseline risk-adjusted NMA, which adjusts for multiple observed and unobserved effect modifiers, was associated with the best model fit. Lack of adjustment for cross-trial differences led to different clinical interpretations of findings. CONCLUSION: Failure to adjust for cross-trial differences in NMA can have important implications for clinical interpretations when studying the comparative efficacy of healthcare interventions.
AIM: The importance of adjusting for cross-study heterogeneity when conducting network meta-analyses (NMAs) was demonstrated using a case study of biologic therapies for moderate-to-severe plaque psoriasis. METHODS: Bayesian NMAs were conducted for Psoriasis Area and Severity Index 90 response. Several covariates were considered to account for cross-trial differences: baseline risk (i.e., placebo response), prior biologic use, body weight, psoriasis duration, age, race and baseline Psoriasis Area and Severity Index score. Model fit was evaluated. RESULTS: The baseline risk-adjusted NMA, which adjusts for multiple observed and unobserved effect modifiers, was associated with the best model fit. Lack of adjustment for cross-trial differences led to different clinical interpretations of findings. CONCLUSION: Failure to adjust for cross-trial differences in NMA can have important implications for clinical interpretations when studying the comparative efficacy of healthcare interventions.
Entities:
Keywords:
Psoriasis Area and Severity Index; biologic; heterogeneity; indirect comparison; network meta-analysis; placebo response; psoriasis
Authors: Laura M Sawyer; Kinga Malottki; Celia Sabry-Grant; Najeeda Yasmeen; Emily Wright; Anne Sohrt; Emma Borg; Richard B Warren Journal: PLoS One Date: 2019-08-14 Impact factor: 3.240
Authors: Emily Wright; Najeeda Yasmeen; Kinga Malottki; Laura M Sawyer; Emma Borg; Carsten Schwenke; Richard B Warren Journal: Dermatol Ther (Heidelb) Date: 2020-12-22