Abstract:
BACKGROUND:Tumor necrosis factor inhibitors (TNFi) are common second-line treatments for rheumatoid arthritis (RA). This study was designed to compare the real-world clinical and economic outcomes between patients with RA who responded to TNFi therapy and those who did not. METHODS:For this retrospective cohort analysis we used medical and pharmacy claims from members of 14 large U.S. commercial health plans represented in the HealthCore Integrated Research Database. Adult patients (aged ≥18 years) diagnosed with RA and initiating TNFi therapy (index date) between 1 January 2007 and 30 April 2014 were included in the study. Treatment response was assessed using a previously developed and validated claims-based algorithm. Patients classified as treatment responders in the 12 months postindex were matched 1:1 to nonresponders on important baseline characteristics, including sex, age, index TNFi agent, and comorbidities. The matched cohorts were then compared on their all-cause and RA-related healthcare resource use, and costs were assessed from a payer perspective during the first, second, and third years postindex using parametric tests, regressions, and a nonparametric bootstrap. RESULTS:A total of 7797 patients met the study inclusion criteria, among whom 2337 (30%) were classified as treatment responders. The responders had significantly lower all-cause hospitalizations, emergency department visits, and physical/occupational therapy visits than matched nonresponders during the first-year postindex. Mean total all-cause medical costs were $5737 higher for matched nonresponders, largely driven by outpatient visits and hospitalizations. Mean all-cause pharmacy costs (excluding costs of biologics) were $354 higher for matched nonresponders. Mean RA-related pharmacy costs (conventional synthetic and biologic drugs), however, were $8579 higher in the responder cohort, driven by higher adherence to their index TNFi agent (p < 0.01 for all comparisons). A similar pattern of cost differentiation was observed over years 2 and 3 of follow-up. CONCLUSIONS:In this real-world study we found that, compared with matched nonresponders, patients who responded to TNFi treatments had lower all-cause medical, pharmacy, and total costs (excluding biologics) up to 3 years from initiation of TNFi therapy. These cost differences between the two cohorts provide a considerable offset to the cost of RA medications and should encourage close monitoring of treatment response to minimize disease progression with appropriate therapy choices.
journal_name
Arthritis Res Therjournal_title
Arthritis research & therapyauthors
Grabner M,Boytsov NN,Huang Q,Zhang X,Yan T,Curtis JRdoi
10.1186/s13075-017-1293-1subject
Has Abstractpub_date
2017-05-15 00:00:00pages
92issue
1eissn
1478-6354issn
1478-6362pii
10.1186/s13075-017-1293-1journal_volume
19pub_type
杂志文章abstract:INTRODUCTION:Angiogenesis plays a critical role in synovial inflammation and joint destruction in rheumatoid arthritis (RA). Vascular endothelial growth factor A (VEGF-A) and angiopoietins are two important mediators of synovial angiogenesis. We have previously developed a novel chimeric decoy receptor, namely, double-...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar4265
更新日期:2013-08-14 00:00:00
abstract:INTRODUCTION:Tumor necrosis factor (TNF) and, possibly, lymphotoxin alpha (LTα) signaling contribute to inflammation and rheumatoid arthritis (RA) pathogenesis. Pateclizumab (anti-lymphotoxin- alpha; MLTA3698A) is a humanized monoclonal antibody that blocks and depletes anti-LTα. This phase 2, randomized, head-to-head,...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13075-014-0467-3
更新日期:2014-10-30 00:00:00
abstract:BACKGROUND:Up to 12% of patients with systemic sclerosis (SSc) have anti-neutrophil cytoplasmic antibodies (ANCA). However, the majority of these patients do not manifest ANCA-associated vasculitis (AAV) and the significance of ANCA in these patients is unclear. The aim of this study is to determine the prevalence of A...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,多中心研究
doi:10.1186/s13075-019-1839-5
更新日期:2019-02-14 00:00:00
abstract:BACKGROUND:Rheumatoid arthritis (RA) has been known to be associated with increased risk of cardiovascular disease (CVD). The aim of this study was to investigate the effects of Tai Chi exercise on CVD risk in elderly women with RA. METHOD:In total, 56 female patients with RA were assigned to either a Tai Chi exercise...
journal_title:Arthritis research & therapy
pub_type: 临床试验,杂志文章
doi:10.1186/s13075-015-0893-x
更新日期:2015-12-24 00:00:00
abstract:INTRODUCTION:Semaphorin 3A (sema3A) and neuropilin-1 (NP-1) play a regulatory role in immune responses and have a demonstrated effect on the course of collagen induced arthritis. This study was undertaken to evaluate the role of sema3A and NP-1 in the pathogenesis of systemic lupus erythematosus (SLE) and the specific ...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar3881
更新日期:2012-06-14 00:00:00
abstract::A variety of cytokines and growth factors use the Janus kinase (Jak)-STAT signaling pathway to transmit extracellular signals to the nucleus. STATs (signal transducers and activators of transcription) are latent cytoplasmic transcription factors. There are seven mammalian STATs and they have critical, nonredundant rol...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,评审
doi:10.1186/ar1197
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Interstitial lung disease (ILD) is a common complication of connective tissue disease (CTD) and a leading cause of morbidity and mortality. There are various lung ultrasound (LUS) scoring systems with different lung intercostal spaces (LIS). The purpose of this meta-analysis was to find a simplified LUS meth...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,meta分析
doi:10.1186/s13075-019-1888-9
更新日期:2019-04-11 00:00:00
abstract:BACKGROUND:Fluorescence optical imaging (FOI) enables visualization of inflammation in the hands in rheumatic joint diseases with currently a lack of long-term follow-up studies. OBJECTIVE:To investigate FOI for treatment monitoring in a homogenous cohort of patients with early (disease duration < 2 years) and active ...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/s13075-019-1989-5
更新日期:2019-09-18 00:00:00
abstract:INTRODUCTION:The revised shared epitope (SE) concept in rheumatoid arthritis (RA) is based on the presence (S) or absence (X) of the SE RAA amino acid motif at positions 72 to 74 of the third hypervariable region of the various human leucocyte antigen (HLA)-DRB1 alleles. The purpose of this study was to investigate SE ...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar3479
更新日期:2011-01-01 00:00:00
abstract::The development of spontaneous autoimmunity in inbred strains of rodents has allowed us to investigate the molecular basis of chronic inflammatory disease in ways that would not be possible in humans. Recently, two new mouse models of autoimmune inflammatory polyarthritis have been reported that demonstrate how altera...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,评审
doi:10.1186/ar1185
更新日期:2004-01-01 00:00:00
abstract::Osteoporosis results from a loss of bone mass and bone structure such that the bone becomes weak and fractures with very little trauma. Until recently, the approved osteoporosis therapies prevented more bone loss by altering osteoclast activity and lifespan. Recently, attention has turned away from osteoclast inhibiti...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,评审
doi:10.1186/ar797
更新日期:2003-01-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was the evaluation of synovial effusion (SE), synovial fluid (SF) and synovial tissue (ST) biomarkers in relation to disease activity indexes to assess the response to intraarticular (IA) tumor necrosis factor (TNF)-α blockers in psoriatic arthritis (PsA). METHODS:Systemic and lo...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar3090
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Monosodium urate monohydrate (MSU) crystals synergize with various toll-like receptor (TLR) ligands to induce cytokine production via activation of the NOD-like receptor (NLR) family, pyrin domain-containing 3 (NLPR3) inflammasome. This has been demonstrated in vitro using human cell lines or monocytes of ...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar3898
更新日期:2012-07-04 00:00:00
abstract:INTRODUCTION:Pateclizumab (MLTA3698A) is a humanized mAb against lymphotoxin α (LTα), a transiently expressed cytokine on activated B and T cells (Th1, Th17), which are implicated in rheumatoid arthritis (RA) pathogenesis. This study was conducted to assess the safety, tolerability, < NOTE: For clarity and per AMA/S-W ...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,随机对照试验
doi:10.1186/ar3554
更新日期:2012-01-08 00:00:00
abstract::Glucocorticoids have successfully been used in the treatment of rheumatoid arthritis. Data suggest that 7alpha-hydroxy-dehydroepiandrosterone (7alpha-OH-DHEA), an immunostimulating metabolite of dehydroepiandrosterone, can block glucocorticoid-induced immune suppression. Formation of 7alpha-OH-DHEA is catalyzed by act...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar1819
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:Mesenchymal stem cells (MSCs) represent promising applications in rheumatoid arthritis (RA). However, the inflammatory niche in the RA synovium could adversely affect MSC function. This study was designed to investigate biologic and immunologic properties of synovium-derived MSCs (SMSCs) in RA, with partic...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar4355
更新日期:2013-10-29 00:00:00
abstract:INTRODUCTION:The purpose of this study was to examine the diagnostic performance of autoantibodies against citrullinated peptides/proteins (ACPA) and to determine the prevalence of HLA-DRB1 shared epitope alleles (SE) in African patients with rheumatoid arthritis (RA). METHODS:Serum levels of anti-cyclic citrullinated...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar2945
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Studies in the spontaneous ankylosis model in aging male DBA/1 mice and in patients with ankylosing spondylitis provide evidence that inflammation and new tissue formation leading to joint or spine ankylosis are likely linked but largely uncoupled processes. We previously proposed the 'entheseal stress' hy...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar3772
更新日期:2012-03-12 00:00:00
abstract::Cardiovascular event rates are markedly increased in rheumatoid arthritis (RA), and RA atherogenesis remains poorly understood. The relative contributions of traditional and nontraditional risk factors to cardiovascular disease in RA await elucidation. The present study comprises three components. First, we compared b...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar1717
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:Degeneration of the intervertebral disc (IVD) is characterized by marked degradation and restructuring of the annulus fibrosus (AF). Although several matrix metalloproteinases (MMPs) have been found to be more prevalent in degenerate discs, their coordination and function within the context of the disease ...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar4224
更新日期:2013-04-27 00:00:00
abstract::Cardiovascular morbidity and mortality are becoming major health concerns for adults with inflammatory rheumatic diseases. The enhanced atherogenesis in this patient population is promoted by the exposure to traditional risk factors as well as nontraditional cardiovascular insults, such as corticosteroid therapy, chro...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,评审
doi:10.1186/ar4212
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:UK guidelines recommend that all early active rheumatoid arthritis (RA) patients are offered combination disease-modifying antirheumatic drugs (DMARDs) and short-term corticosteroids. Anti-citrullinated protein antibody (ACPA)-positive and ACPA-negative RA may differ in their treatment responses. We used d...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,随机对照试验
doi:10.1186/ar4439
更新日期:2014-01-16 00:00:00
abstract::Inflammation and inflammatory responses are modulated by a bidirectional communication between the neuroendocrine and immune system. Many lines of research have established the numerous routes by which the immune system and the central nervous system (CNS) communicate. The CNS signals the immune system through hormona...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,评审
doi:10.1186/ar1002
更新日期:2003-01-01 00:00:00
abstract:INTRODUCTION:In the present systematic review and meta-analysis, we assessed the effectiveness of different forms of balneotherapy (BT) and hydrotherapy (HT) in the management of fibromyalgia syndrome (FMS). METHODS:A systematic literature search was conducted through April 2013 (Medline via Pubmed, Cochrane Central R...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,meta分析,评审
doi:10.1186/ar4603
更新日期:2014-07-07 00:00:00
abstract:INTRODUCTION:Systemic lupus erythematosus (SLE) patients have lower bone mineral density and increased fracture risk when compared with healthy individuals, due to distinct factors and mechanisms. Bone remodeling is a tightly orchestrated process dependent on several factors, including the balance between receptor acti...
journal_title:Arthritis research & therapy
pub_type: 杂志文章,多中心研究
doi:10.1186/ar3500
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Physical activity has been recommended to patients with knee osteoarthritis for improving their symptoms. However, it is still controversial if physical activity has effects on joint structures including cartilage volume. The aim of this study was to describe the associations between physical activity and ...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/s13075-015-0813-0
更新日期:2015-10-26 00:00:00
abstract:INTRODUCTION:High levels of the oncoprotein survivin may be detected in the majority of patients with early rheumatoid arthritis (RA). Survivin is a sensitive predictor of joint damage and persistent disease activity. Survivin-positive patients are often poor responders to antirheumatic and biological treatment. The ai...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar4438
更新日期:2014-01-16 00:00:00
abstract:INTRODUCTION:Intraarticular administration of autologous conditioned serum (ACS) recently demonstrated some clinical effectiveness in treatment of osteoarthritis (OA). The current study aims to evaluate the in vitro effects of ACS on cartilage proteoglycan (PG) metabolism, its composition and the effects on synovial fl...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar3050
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to determine whether serum biomarkers for degradation and synthesis of the extracellular matrix of cartilage are associated with, and can predict, radiographic damage in patients with rheumatoid arthritis (RA). METHODS:Clinical and radiographic data of 87 RA patients were r...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar1882
更新日期:2006-01-01 00:00:00
abstract::The present studies were initiated to determine the protein expression patterns of fibroblast-like synovial (FLS) cells derived from the synovia of rheumatoid arthritis patients. The cellular proteins were separated by two-dimensional polyacrylamide gel electrophoresis and the in-gel digested proteins were analyzed by...
journal_title:Arthritis research & therapy
pub_type: 杂志文章
doi:10.1186/ar1153
更新日期:2004-01-01 00:00:00