scholarly journals BL1 COST-EFFECTIVENESS, VALUE OF INFORMATION, AND BUDGET IMPACT OF CERTOLIZUMAB PEGOL COMPARED TO SUBCUTANEOUS TUMOR NECROSIS FACTOR (TNF) INHIBITORS AND METHOTREXATE IN THE TREATMENT OF MODERATE-TO-SEVERE RHEUMATOID ARTHRITIS IN FINLAND

2010 ◽  
Vol 13 (7) ◽  
pp. A243 ◽  
Author(s):  
EJ Soini ◽  
T Hallinen ◽  
M Taiha ◽  
V Honkanen
2019 ◽  
Vol 47 (4) ◽  
pp. 493-501
Author(s):  
Paul Emery ◽  
Bonnie Vlahos ◽  
Piotr Szczypa ◽  
Mazhar Thakur ◽  
Heather E. Jones ◽  
...  

Objective.To evaluate longterm drug survival (proportion of patients still receiving treatment) and discontinuation of etanercept (ETN), infliximab (IFX), adalimumab (ADA), certolizumab pegol (CZP), and golimumab (GOL) using observational data from patients with rheumatoid arthritis (RA).Methods.Following a systematic literature review, drug survival at 12 and 12–24 months of followup was estimated by summing proportions of patients continuing treatment and dividing by number of studies. Drug survival at ≥ 36 months of followup was estimated through Metaprop.Results.There were 170 publications included. In the first-line setting, drug survival at 12 months with ETN, IFX, or ADA was 71%, 69%, and 70%, respectively, while at 12–24 months the corresponding rates were 63%, 57%, and 59%. In the second-line setting, drug survival at 12 months with ETN, IFX, or ADA was 61%, 69%, and 55%, respectively, while at 12–24 months the corresponding rates were 53%, 39%, and 43%. Drug survival at ≥ 36 months with ETN, IFX, or ADA in the first-line setting was 59% (95% CI 46–72%), 49% (95% CI 43–54%), and 51% (95% CI 41–60%), respectively, while in the second-line setting the corresponding rates were 56% (95% CI 52–61%), 48% (95% CI 40–55%), and 41% (95% CI 36–47%). Discontinuation of ETN, IFX, and ADA at 36 months of followup was 38–48%, 42–62%, and 38–59%, respectively. Data on CZP and GOL were scarce.Conclusion.After > 12 months of followup, more patients with RA receiving ETN remain on treatment compared with other tumor necrosis factor inhibitors.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1144.1-1144
Author(s):  
K. Saadaoui ◽  
H. Sahli ◽  
S. Boussaid ◽  
J. Samia ◽  
R. Sonia ◽  
...  

Background:Tumor necrosis factor (TNF) blocking agents are effective in treating rheumatoid arthritis, but they are associated with several adverse effects and high costs. Some studies have assessed the effectiveness of down-titration compared with continuation of standard dose.Objectives:The aim of our study is to assess dose tapering in Tunisia.Methods:A retrospective study including 170 rheumatoid arthritis patients treated by TNF blocker agent and with either low disease activity or remission (ACR/EULAR criteria). Two groups were compared, in the first group (G1) the interval of TNFi administration was extended, in the second group (G2) the standard dose and rhythm of administration were maintained.Results:The TNFi tapering group (G1) included 96 persons whereas the group having the same drug administration rhythm (G2) included 74 case. The baseline age of the down-dosing drug group was 56.6 ± 12.6 years versus 52.9 ± 11.6 years in the other group (p = 0.046) and the average disease duration were respectively 12.3 ± 7.2 years versus 11.2 ± 6 years (p = 0.346). Women represented 88.5% in G1 versus 93% in G2 (p = 0.298). Rheumatoid Factors and ACPA were positive respectively in (85.5% versus 83.8; p = 0.748) and (76.4% versus 67.8%; p= 0.309). Etanercept, adalimumab, certolizumab pegol and infliximab were respectively used in 84.4%, 9.4%, 4.2% and 2.1% cases (G1), whereas they were used in 48.6%, 16.2%, 27% and 8.1% cases in the second group (G2). In the TNFi down dosing group, methotrexate was associated to TNFi in 74% cases while 71.6% of patient received methotrexate in the standard rhythm of administration group (p = 0.734). Corticosteroids were used by 40.6% of patients in G1 vs. 56.8% of patients in G2 (p = 0.037). The average DAS28 at baseline was 5.91 ± 0.81 (G1) versus 5.95 ± 0.80 (G2) (p = 0.759). There was no statistically significant difference between the two groups for rates of TNFi withdrawal (p = 0.798). In fact, TNFi was interrupted due to inefficacy for 17 patients (17.7%) in the down-dosing group versus 12 patients (16.2%) in the other group.Conclusion:Our study add evidence that TNFi drugs tapering could be equivalent to maintenance strategy. This could be beneficial to decrease the risk of adverse effect or reduce costs. Further studies are needed to confirm those results and identify patients who could benefit of TNFi administration rhythm step-down.Disclosure of Interests:None declared


2006 ◽  
Vol 55 (1) ◽  
pp. 150-153 ◽  
Author(s):  
Carlos Gonzalez-Juanatey ◽  
Javier Llorca ◽  
Carlos Garcia-Porrua ◽  
Javier Martin ◽  
Miguel A. Gonzalez-Gay

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