Abstract：
PURPOSE OF REVIEW:One justification for using expensive biologic therapy in rheumatoid arthritis (RA) has been that it can reduce future healthcare utilization such as joint surgeries and physician visits. However, the evidence to support this assertion is unclear. We conducted a review of the literature for studies which have analyzed the trends in resource use of RA patients, and then undertook a retrospective observational analysis of a Canadian administrative database using instrumental variable methods. RECENT FINDINGS:Our review found a trend in reduced resource utilization prior to the introduction of biologics and no evidence that biologic therapies have specifically contributed to this reduction. Our observational analysis, which overcame some of the epidemiological challenges with determining the influence of biologics on resource utilization, found a possible reduction in other medications but possible increases rather than decreases in physician visits and hospitalizations. However, our sample was not sufficiently large to make definitive conclusions. Over 15 years since the introduction of biologics for RA, no evidence exists supporting the assumption that biologic therapies reduce future healthcare utilization. While such a question is challenging to generate evidence for, and so an absence of evidence does not suggest that the hypothesis is incorrect, an instrumental variable analysis using sufficient data could provide definitive evidence.
journal_name
Curr Rheumatol Repjournal_title
Current rheumatology reportsauthors
Bansback N,Fu E,Sun H,Guh D,Zhang W,Lacaille D,Milbers K,Anis AHdoi
10.1007/s11926-017-0680-6subject
Has Abstractpub_date
2017-09-01 00:00:00pages
54issue
9eissn
1523-3774issn
1534-6307pii
10.1007/s11926-017-0680-6journal_volume
19pub_type
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journal_title：Current rheumatology reports
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journal_title：Current rheumatology reports
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journal_title：Current rheumatology reports
pub_type： 杂志文章,评审
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journal_title：Current rheumatology reports
pub_type： 杂志文章,评审
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journal_title：Current rheumatology reports
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journal_title：Current rheumatology reports
pub_type： 杂志文章,评审
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更新日期：2019-07-24 00:00:00
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pub_type： 杂志文章,评审
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更新日期：2020-06-19 00:00:00
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journal_title：Current rheumatology reports
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journal_title：Current rheumatology reports
pub_type： 杂志文章,评审
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journal_title：Current rheumatology reports
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abstract：:Gout and hyperuricemia have long been suspected to be risk factors for cardiovascular disease. However, studies have frequently failed to distinguish whether these entities have an independent effect on cardiovascular risk or serve as markers for other risk factors. In vitro and animal studies suggest that uric acid i...
journal_title：Current rheumatology reports
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journal_title：Current rheumatology reports
pub_type： 杂志文章,评审
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abstract：:Large epidemiologic studies of gout can improve insight into the etiology, pathology, impact, and management of the disease. Identification of monosodium urate monohydrate crystals is considered the gold standard for diagnosis, but its application is often not possible in large studies. Therefore, under such circumsta...
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