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Study results show higher rates of dose escalation in certain TNFi agents
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Similar persistence and clinical disease activity were seen after treatment with adalimumab, etanercept and infliximab; however, rates of dose escalation were highest with adalimumab and infliximab, and overall costs were higher for infliximab without increases in effectiveness, according to study results.
Researchers analyzed observational data from the Veterans Affairs Rheumatoid Arthritis (VARA) registry and linked administrative databases for longitudinal data from VARA patients who initiated treatment with adalimumab, etanercept or infliximab from 2003 to 2010. Outcomes included Disease Activity Score using 28 joints (DAS28), treatment persistence, dose escalation and direct costs of drugs and drug administration.
Study results showed baseline DAS28, DAS28 improvements and persistence on initial treatment were similar across tumor necrosis factor inhibitor (TNFi) agents for 563 eligible patients. Compared with patients taking adalimumab or infliximab, fewer patients receiving etanercept underwent dose escalation. The researchers also found lower annual costs for injectable adalimumab and etanercept vs. intravenously administered infliximab.
Disclosure: Research was sponsored by Immunex, Wyeth and by VA Health Services Research and Development Grant SHP 08-172.
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