Cost-Effectiveness of Biologics as First-Line Treatment of Rheumatoid Arthritis: Case Closed?
Authors: Maarten Boers
Journal: Annals of Internal Medicine (2009)

Editorials3 November 2009Cost-Effectiveness of Biologics as First-Line Treatment of Rheumatoid Arthritis: Case Closed?Maarten Boers, MSc, MD, PhDMaarten Boers, MSc, MD, PhDFrom VU University Medical Center, Amsterdam, The Netherlands.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-9-200911030-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Rheumatoid arthritis (RA) is an autoimmune, multisystem disease characterized by chronic inflammation and, ultimately, destruction of joints. Left unchecked, it leads to a high burden of disease, early loss of work capacity, major morbidity, and increased mortality. The concept of a window of opportunity—that early and aggressive treatment could prevent many of the long-term consequences of the disease—was introduced in the early 1990s (1). The drugs available at that time, including disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids, were tested in different combination strategies and proven through tight-control strategies to be effective in both the short and the long term. Treatment ...References1. Boers M. Understanding the window of opportunity concept in early rheumatoid arthritis [Editorial]. Arthritis Rheum. 2003;48:1771-4. [PMID: 12847667] CrossrefMedlineGoogle Scholar2. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, Hazes JM, et al. Comparison of treatment strategies in early rheumatoid arthritis: a randomized trial. Ann Intern Med. 2007;146:406-15. [PMID: 17371885] LinkGoogle Scholar3. Boers M. Add-on or step-up trials for new drug development in rheumatoid arthritis: a new standard? Arthritis Rheum. 2003;48:1481-3. [PMID: 12794813] CrossrefMedlineGoogle Scholar4. Finckh A, Bansback N, Marra CA, Anis AH, Michaud K, Lubin S, et al. Treatment of very early rheumatoid arthritis with symptomatic therapy, disease-modifying antirheumatic drugs, or biologic agents. A cost-effectiveness analysis. Ann Intern Med. 2009;151:612-21. LinkGoogle Scholar5. Gabriel S, Drummond M, Maetzel A, Boers M, Coyle D, Welch V, et al; Patient Perspective Group. OMERACT 6 Economics Working Group report: a proposal for a reference case for economic evaluation in rheumatoid arthritis. J Rheumatol. 2003;30:886-90. [PMID: 12672223] MedlineGoogle Scholar6. van den Hout WB, Goekoop-Ruiterman YP, Allaart CF, de Vries-Bouwstra JK, Hazes JM, Kerstens PJ, et al. Cost-utility analysis of treatment strategies in patients with recent-onset rheumatoid arthritis. Arthritis Rheum. 2009;61:291-9. [PMID: 19248130] CrossrefMedlineGoogle Scholar7. Kirwan JR, Bijlsma JW, Boers M, Shea BJ. Effects of glucocorticoids on radiological progression in rheumatoid arthritis. Cochrane Database Syst Rev. 2007;:CD006356. [PMID: 17253590] MedlineGoogle Scholar8. van Everdingen AA, Jacobs JW, Siewertsz Van Reesema DR, Bijlsma JW. Low-dose prednisone therapy for patients with early active rheumatoid arthritis: clinical efficacy, disease-modifying properties, and side effects: a randomized, double-blind, placebo-controlled clinical trial. Ann Intern Med. 2002;136:1-12. [PMID: 11777359] LinkGoogle Scholar9. Jacobsson LT, Turesson C, Nilsson JA, Petersson IF, Lindqvist E, Saxne T, et al. Treatment with TNF blockers and mortality risk in patients with rheumatoid arthritis. Ann Rheum Dis. 2007;66:670-5. [PMID: 17158824] CrossrefMedlineGoogle Scholar10. Boers M, Dijkmans B, Gabriel S, Maradit-Kremers H, O'Dell J, Pincus T. Making an impact on mortality in rheumatoid arthritis: targeting cardiovascular comorbidity. Arthritis Rheum. 2004;50:1734-9. [PMID: 15188348] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From VU University Medical Center, Amsterdam, The Netherlands.Disclosures:Consultancies: M. Boers (Roche, Nitec, Mapi Values, GlaxoSmithKline). Honoraria: M. Boers (Sanofi, Novartis, Merck, Astra, Nicox, Savient, Combinatorx, Astellas MedImmune, Schering-Plough).Corresponding Author: Maarten Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, VU University Medical Center, PK 6Z 185, Box 7057, 1007 MB, Amsterdam, the Netherlands; e-mail, [email protected]nl. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Very Early Rheumatoid Arthritis With Symptomatic Therapy, Disease-Modifying Antirheumatic Drugs, or Biologic Agents Axel Finckh , Nick Bansback , Carlo A. Marra , Aslam H. Anis , Kaleb Michaud , Stanley Lubin , Marc White , Sonia Sizto , and Matthew H. Liang Cost-Effectiveness of Biologics in Early Rheumatoid Arthritis Axel Finckh , Nick Bansback , and Matthew H. Liang Cost-Effectiveness of Biologics in Early Rheumatoid Arthritis Maarten Boers Metrics Cited ByMeasuring the bioactivity of anti-IL-6/anti-IL-6R therapeutic antibodies: presentation of a robust reporter gene assayIL-6 inhibitors for treatment of rheumatoid arthritis: past, present, and futureRethinking the discordance between guidelines and practice in rheumatoid arthritis treatmentEditorialCertolizumab pegol: a new biologic targeting rheumatoid arthritisNovel approaches to incorporating pharmacoeconomic studies into phase III clinical trials for Alzheimer's diseaseCost-Effectiveness of Biologics in Early Rheumatoid ArthritisAxel Finckh, MD, MS, Nick Bansback, MS, and Matthew H. Liang, MD, MPHDevolving therapeutic pyramids 3 November 2009Volume 151, Issue 9Page: 668-669KeywordsDrugsGlucocorticoid therapyInformation storage and retrievalNSAIDsQuality of life ePublished: 3 November 2009 Issue Published: 3 November 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...