Overviews of reviews –methodological considerations of the Biologics for rheumatoid arthritis Cochrane overview

Oral
2010 Keystone
Tanjong-Ghogomu E1, Singh J2, Christensen R3, Wells G4, Suarez-Almazor M5, Buchbinder R6, Lopez-Olivo A7, Tugwell P8
1Institute of Population Health, Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada
2Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
3The Parker Institute: Musculoskeletal Statistics Unit, Frederiksberg Hospital, Copenhagen, Denmark
4Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
5General InternalMedicine, Ambulatory Treatment and Emergency Care, MD Anderson Cancer Center, Houston, Texas, United States;
6Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
7General Internal Medicine, Ambulatory Treatment and Emergency Care, MD Anderson Cancer Center, Houston, Texas, United States
8Institute of Population Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada

Background:

Cochrane Overviews of reviews (Cochrane Overviews) are Cochrane reviews designed to compile evidence from multiple systematic reviews of interventions for a single health condition into one accessible and usable document. They are becoming more popular as they summarize evidence for efficacy and safety of the interventions considered. General methods are described in the Cochrane Handbook.

Objectives:

To compare the methodology for Cochrane overviews as described in the Cochrane Handbook with the methods used in an overview of the efficacy and safety of abatacept, adalimumab, anakinra, etanercept, infliximab, and rituximab in patients with rheumatoid arthritis (RA).

Methods:

We undertook an overview of Cochrane reviews for biologics in RA. In order to perform indirect comparisons of the six biologics using network meta-analysis methodology we had to expand on the methodology envisioned for Cochrane overviews in the Cochrane Handbook. We compared the methods we used for the biologics for RA overview to those in the Handbook and described the additional data needed for our analysis.

Results:

Data for all the outcomes considered in the overview were not available in the individual systematic reviews and more information was needed from the original studies.

Conclusion:

Our experience showed that data extraction from original studies and re-analysis are necessary for a comprehensive overview of different treatments for a single condition.