Abstract | INTRODUCTION: The purpose of this study was to evaluate clinical outcomes and drug/administration costs of treatment with tumor necrosis factor inhibitor (TNFi) agents in US veterans with rheumatoid arthritis (RA) initiating TNFi therapy. The analysis compared patients initiating and continuing a single TNFi with patients who subsequently switched to a different TNFi. METHODS: RESULTS: Of 563 eligible patients, 262 initiated a single TNFi therapy, 142 restarted their initial TNFi after a ≥90-day gap in treatment (interrupted therapy), and 159 switched to a different TNFi. Patients who switched had higher mean DAS28 before starting TNFi therapy than patients with single or interrupted therapy: 5.3 vs 4.5 or 4.6, respectively. Mean duration of the first course was 34.3 months for single therapy, 18.3 months for interrupted therapy, and 17.7 months for switched therapy. Mean post-treatment DAS28 was highest for patients who switched TNFi. Mean annualized costs for first course were $13,800 for single therapy, $13,200 for interrupted therapy, and $14,200 for switched therapy; mean annualized costs for second course were $12,800 for interrupted therapy and $15,100 for switched therapy. CONCLUSION: Patients who switched TNFi had higher pre-treatment DAS28 and higher overall costs than patients who received the same TNFi as either single or interrupted therapy. FUNDING: This research was funded by Immunex Corp., a fully owned subsidiary of Amgen Inc., and by VA HSR&D Grant SHP 08-172.
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Authors | Grant W Cannon, Scott L DuVall, Candace L Haroldsen, Liron Caplan, Jeffrey R Curtis, Kaleb Michaud, Ted R Mikuls, Andreas Reimold, David H Collier, George J Joseph, David J Harrison, Brian C Sauer |
Journal | Advances in therapy
(Adv Ther)
Vol. 33
Issue 8
Pg. 1347-59
(08 2016)
ISSN: 1865-8652 [Electronic] United States |
PMID | 27352377
(Publication Type: Journal Article, Observational Study)
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Chemical References |
- Antirheumatic Agents
- Tumor Necrosis Factor-alpha
- Infliximab
- Adalimumab
- Etanercept
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Topics |
- Adalimumab
(economics, therapeutic use)
- Aged
- Antirheumatic Agents
(administration & dosage, economics, therapeutic use)
- Arthritis, Rheumatoid
(drug therapy)
- Drug Substitution
- Etanercept
(economics, therapeutic use)
- Female
- Humans
- Infliximab
(economics, therapeutic use)
- Male
- Middle Aged
- Observational Studies as Topic
- Treatment Outcome
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors, economics)
- United States
- Veterans
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