The efficacy and safety of adalimumab in treating axial spondyloarthritis: a systematic review and meta-analysis
- 1Xi’an Honghui Hospital, Xi’an Jiaotong University
- 2Hospital of Orthopaedic Injuries, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine
- 3Baoji No.2 Hospital of Traditional Chinese Medicine
Abstract
Background Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disorder. Multiple randomized controlled trials (RCTs) have verified the efficacy of adalimumab for axSpA. Nevertheless, few integrated analyses explore its time-varying efficacy across different disease subtypes and age groups, and the optimal treatment time point and full respiratory disorders remain unclear. Methods We searched four electronic databases for eligible RCTs up to September 1, 2022. Two researchers independently screened literature and extracted data. Methodological bias was assessed using the Cochrane risk-of-bias tool, and Stata 15.0 was adopted for quantitative meta-analysis. Results Nine studies involving 1113 patients were included. At week 12, adalimumab significantly increased ASAS20 [RR = 2.36, 95% CI (1.94, 2.87)], ASAS40 [RR = 3.16, 95% CI (2.46, 4.06)], ASAS5/6 [RR = 4.07, 95% CI (3.09, 5.37)] and ASAS partial remission [RR = 5.29, 95% CI (3.02, 9.26)] response rates. Disease activity indicators, including ASDAS [SMD = -1.31, 95% CI (-1.52, -1.09)] and BASDAI [SMD = -0.81, 95% CI (-0.99, -0.63)], were significantly lower, while CRP [SMD = -0.52, 95% CI (-0.70, -0.35)], total back pain [SMD = -0.68, 95% CI (-0.86, -0.49)], nighttime back pain [SMD = -0.69, 95% CI (-0.88, -0.50)], BASMI [SMD = -0.39, 95% CI (-0.58, -0.20)] and BASFI [SMD = -0.60, 95% CI (-0.77, -0.42)] were also markedly reduced. No significant between-group difference was detected in the incidence of adverse events. Discussion Adalimumab achieves peak efficacy at week 12, with comparable efficacy in radiographic and non-radiographic axSpA, and works effectively in adolescents aged ≥ 12 years. Despite possible infections, respiratory disorders and liver dysfunction, adalimumab possesses a favorable safety profile. These results underpin its standardized clinical use for axSpA.
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BibTeX
@article{dong2026efficacy,
title = {{The efficacy and safety of adalimumab in treating axial spondyloarthritis: a systematic review and meta-analysis}},
author = {Bo Dong and Ani Ma and Weidong Yue},
journal = {BMC Musculoskeletal Disorders},
year = {2026},
month = jul,
doi = {10.1186/s12891-026-10251-y},
url = {https://doi.org/10.1186/s12891-026-10251-y},
note = {CC BY},
}
RIS
TY - JOUR
TI - The efficacy and safety of adalimumab in treating axial spondyloarthritis: a systematic review and meta-analysis
AU - Bo Dong
AU - Ani Ma
AU - Weidong Yue
PY - 2026
DA - 2026/07/01
JO - BMC Musculoskeletal Disorders
DO - 10.1186/s12891-026-10251-y
UR - https://doi.org/10.1186/s12891-026-10251-y
AB - Background Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disorder. Multiple randomized controlled trials (RCTs) have verified the efficacy of adalimumab for axSpA. Nevertheless, few integrated analyses explore its time-varying efficacy across different disease subtypes and age groups, and the optimal treatment time point and full respiratory disorders remain unclear. Methods We searched four electronic databases for eligible RCTs up to September 1, 2022. Two researchers independently screened literature and extracted data. Methodological bias was assessed using the Cochrane risk-of-bias tool, and Stata 15.0 was adopted for quantitative meta-analysis. Results Nine studies involving 1113 patients were included. At week 12, adalimumab significantly increased ASAS20 [RR = 2.36, 95% CI (1.94, 2.87)], ASAS40 [RR = 3.16, 95% CI (2.46, 4.06)], ASAS5/6 [RR = 4.07, 95% CI (3.09, 5.37)] and ASAS partial remission [RR = 5.29, 95% CI (3.02, 9.26)] response rates. Disease activity indicators, including ASDAS [SMD = -1.31, 95% CI (-1.52, -1.09)] and BASDAI [SMD = -0.81, 95% CI (-0.99, -0.63)], were significantly lower, while CRP [SMD = -0.52, 95% CI (-0.70, -0.35)], total back pain [SMD = -0.68, 95% CI (-0.86, -0.49)], nighttime back pain [SMD = -0.69, 95% CI (-0.88, -0.50)], BASMI [SMD = -0.39, 95% CI (-0.58, -0.20)] and BASFI [SMD = -0.60, 95% CI (-0.77, -0.42)] were also markedly reduced. No significant between-group difference was detected in the incidence of adverse events. Discussion Adalimumab achieves peak efficacy at week 12, with comparable efficacy in radiographic and non-radiographic axSpA, and works effectively in adolescents aged ≥ 12 years. Despite possible infections, respiratory disorders and liver dysfunction, adalimumab possesses a favorable safety profile. These results underpin its standardized clinical use for axSpA.
SN - 1471-2474
ER -