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lüll A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness Chen YF; Jobanputra P; Barton P; Jowett S; Bryan S; Clark W; Fry-Smith A; Burls AHealth Technol Assess 2006[Nov]; 10 (42): iii-iv, xi-xiii, 1-229OBJECTIVES: This report reviews the clinical effectiveness and cost-effectiveness of adalimumab, etanercept and infliximab, agents that inhibit tumour necrosis factor-alpha (TNF-alpha), when used in the treatment of rheumatoid arthritis (RA) in adults. DATA SOURCES: Electronic databases were searched up to February 2005. REVIEW METHODS: Systematic reviews of the literature on effectiveness and cost-effectiveness were undertaken and industry submissions to the National Institute for Health and Clinical Excellence (NICE) were reviewed. Meta-analyses of effectiveness data were also undertaken for each agent. The Birmingham Rheumatoid Arthritis Model (BRAM), a simulation model, was further developed and used to produce an incremental cost-effectiveness analysis. RESULTS: Twenty-nine randomised controlled trials (RCTs), most of high quality, were included. The only head-to-head comparisons were against methotrexate. For patients with short disease duration (|Adalimumab[MESH]|Antibodies, Monoclonal, Humanized[MESH]|Antibodies, Monoclonal/administration & dosage/economics/*therapeutic use[MESH]|Antirheumatic Agents/administration & dosage/economics/*therapeutic use[MESH]|Arthritis, Rheumatoid/*drug therapy/economics[MESH]|Cost-Benefit Analysis[MESH]|Drug Costs[MESH]|Etanercept[MESH]|Humans[MESH]|Immunoglobulin G/administration & dosage/economics/*therapeutic use[MESH]|Infliximab[MESH]|Quality-Adjusted Life Years[MESH]|Randomized Controlled Trials as Topic[MESH]|Receptors, Tumor Necrosis Factor/administration & dosage/*therapeutic use[MESH]|Treatment Outcome[MESH]|United Kingdom[MESH] |