Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


OBJECTIVE: The objective of this selective EBM review is to determine whether or not CTP13 is as good as infliximab in controlling pain in adult patients with rheumatoid arthritis.

STUDY DESIGN: A review of three double-blind randomized controlled trials that were published in English after 2008 were used.

DATA SOURCES: Data sources include peer reviewed articles that were published on PubMed database. They were selected based on their relevance to the research question as well as patient measured outcomes.

OUTCOMES MEASURED: The outcomes measured include efficacy of the drug measured through Visual Analog Scale (VAS), pain on DAS28 scale and pain on the ACR20 scale.

RESULTS: All three studies found that CT-P13 was as effective in reducing pain when compared to infliximab in treating rheumatoid arthritis. One study found that the mean change from baseline using the VAS +/- SD was -30.2 +/- 28 for CT-P13 and was -28 +/- 26.9 for infliximab with a 95% CI (Yoo DH, Racewicz A, Brzezicki J, et al. Arthritis Res Ther. 2016;18. doi: 10.1186/s13075-016-0981-6). Another study compared the change in the DAS28 score and saw the mean decrease from baseline of 2.2 with infliximab and 2.1 with CT-P13 with a CI of 95% (Jørgensen KK, Olsen IC, Goll GL, Lorentzen M, Bolstad N, Haavardsholm EA, Lundin KE, Mørk C, Jahnsen J, Kvien TK, Lancet. 2017;389(10086):2304-2316 doi: 10.1016/S0140- 6736(17)30068-5). In Yoo, Prodanovic, Jaworski J, et al. the mean change in VAS from week 54 to week 102 for the maintenance group and switch group was -1.1 and -2.6 (Ann Rheum Di. 2017;76(2):355-363. doi: 10.1136/annrheumdis-2015-208786).

CONCLUSION: Two studies were able to statistically show that CT-P13 was able to improve pain as well as infliximab and one study results were inconclusive as to whether CT-P13 was as effective as infliximab in controlling pain in patients with RA