Your drug info question is below. Keep in mind, oftentimes I will include a bunc

Your drug info question is below. Keep in mind, oftentimes I will include a bunch of smaller questions that should help answer the bigger question, but there may be other things that you find that I do not include:

Also, I’d recommend referring to UpToDate, EULAR Rheumatoid Arthritis guidelines, and ACR Rheumatoid Arthritis Guidelines for generally knowing RA treatment. (UpToDate is the easiest if you have access). For the above, I DO want you to look at any current meta-analyses or systematic reviews to help craft your answer. I do not want you to refer to randomized control trials or observational trials UNLESS they are answering something that the meta-analyses or systematic reviews are not addressing.

Part 1: In rheumatoid arthritis (RA) after the failure of nonbiologic DMARDs, we typically use the following drug classes next: TNFa inhibitors, JAK inhibitors, IL6, IL1R, antiCD20, and immunosuppressants (specifically abatacept). Current guidelines allow the use of any of these after the failure of nonbiologic DMARDs, but they do not directly state which of these therapies to use first. So, the question is what does the current evidence say as to which drug therapies outperform all others?
So, what review articles are out there that compares all non-biologic DMARDs to each other?
How are these review articles deciding which is best?
Which specific medications of the above drug classes tend to be the most recommended based on the data from these review articles
Just to help you out, here are some articles I found. Feel free to use these, BUT there may be other similar articles out there. I used the key words “rheumatoid arthritis biologic therapies comparison” BUT you may want to explore other phrases. I also select the ‘review’ article option in most search engines. I use either Google scholar or PubMed.
Network meta‐analysis of tofacitinib versus biologic treatments in moderate‐to‐severe rheumatoid arthritis patients – Camean‐Castillo – 2019 – Journal of Clinical Pharmacy and Therapeutics – Wiley Online Library
https://www.cureus.com/articles/93507-tumor-necrosis-factor-alpha-inhibitors-and-cardiovascular-risk-in-rheumatoid-arthritis-a-systematic-review.pdf
You can also utilize references included from UpToDate
Part 2: Of the class of TNFa inhibitors, there are both infusion and self-injectable therapies. Recall infusions are therapies where the patient actually has to sit for 30 min or more with an IV and receive the therapy over time – obviously this is more inconvenient, but they are typically being monitored by a healthcare provider to either adjust dose or monitor for any effects. Self-injectable therapies require no healthcare provider – the patient just gets the injectable and they can inject themselves at the convenience of their own home. So:
What does the literature say regarding whether an infused therapy vs self-injectable TNFalpha inhibitors is preferred in RA patients? (You do NOT need to focus on randomized controlled trials or observational trials, it should be mainly from meta-analyses or systematic reviews)
Again, some example articles I found. I used keywords: “infusion vs self-injectable tnf inhibitors administration rheumatoid arthritis.”
Trends in the Use of Biologic Agents Among Rheumatoid Arthritis Patients Enrolled in the US Medicare Program – Zhang – 2013 – Arthritis Care & Research – Wiley Online Library
Rheumatoid Arthritis: An Updated Overview of Latest Therapy and Drug Delivery – PMC (nih.gov)
You’ll notice there are studies outside of our population (For example, Medicare vs commercial; however, I do not care as much about this only because there’s a low volume of studies out there anyway)