Bayesian inference for network meta-regression using multivariate random effects with applications to cholesterol lowering drugs.

TitleBayesian inference for network meta-regression using multivariate random effects with applications to cholesterol lowering drugs.
Publication TypeJournal Article
Year of Publication2019
AuthorsLi, Hao, Ming-Hui Chen, Joseph G. Ibrahim, Sungduk Kim, Arvind K. Shah, Jianxin Lin, and Andrew M. Tershakovec
JournalBiostatistics
Volume20
Issue3
Pagination499-516
Date Published2019 07 01
ISSN1468-4357
KeywordsAnticholesteremic Agents, Bayes Theorem, Cholesterol, LDL, Humans, Hypercholesterolemia, Models, Statistical, Network Meta-Analysis, Regression Analysis
Abstract

Low-density lipoprotein cholesterol (LDL-C) has been identified as a causative factor for atherosclerosis and related coronary heart disease, and as the main target for cholesterol- and lipid-lowering therapy. Statin drugs inhibit cholesterol synthesis in the liver and are typically the first line of therapy to lower elevated levels of LDL-C. On the other hand, a different drug, Ezetimibe, inhibits the absorption of cholesterol by the small intestine and provides a different mechanism of action. Many clinical trials have been carried out on safety and efficacy evaluation of cholesterol lowering drugs. To synthesize the results from different clinical trials, we examine treatment level (aggregate) network meta-data from 29 double-blind, randomized, active, or placebo-controlled statins +/$-$ Ezetimibe clinical trials on adult treatment-naïve patients with primary hypercholesterolemia. In this article, we propose a new approach to carry out Bayesian inference for arm-based network meta-regression. Specifically, we develop a new strategy of grouping the variances of random effects, in which we first formulate possible sets of the groups of the treatments based on their clinical mechanisms of action and then use Bayesian model comparison criteria to select the best set of groups. The proposed approach is especially useful when some treatment arms are involved in only a single trial. In addition, a Markov chain Monte Carlo sampling algorithm is developed to carry out the posterior computations. In particular, the correlation matrix is generated from its full conditional distribution via partial correlations. The proposed methodology is further applied to analyze the network meta-data from 29 trials with 11 treatment arms.

DOI10.1093/biostatistics/kxy014
Alternate JournalBiostatistics
Original PublicationBayesian inference for network meta-regression using multivariate random effects with applications to cholesterol lowering drugs.
PubMed ID29912318
PubMed Central IDPMC6676556
Grant ListP01 CA142538 / CA / NCI NIH HHS / United States
R01 GM070335 / GM / NIGMS NIH HHS / United States
Project: