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2017 ; 37
(7
): 1111-1123
Nephropedia Template TP
gab.com Text
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English Wikipedia
Cost per response for abatacept versus adalimumab in rheumatoid arthritis by ACPA
subgroups in Germany, Italy, Spain, US and Canada
#MMPMID28560470
Weijers L
; Baerwald C
; Mennini FS
; Rodríguez-Heredia JM
; Bergman MJ
; Choquette D
; Herrmann KH
; Attinŕ G
; Nappi C
; Merino SJ
; Patel C
; Mtibaa M
; Foo J
Rheumatol Int
2017[Jul]; 37
(7
): 1111-1123
PMID28560470
show ga
Rheumatoid arthritis (RA) is a chronic inflammatory disorder leading to
disability and reduced quality of life. Effective treatment with biologic DMARDs
poses a significant economic burden. The Abatacept versus Adalimumab Comparison
in Biologic-Naďve RA Subjects with Background Methotrexate (AMPLE) trial was a
head-to-head, randomized study comparing abatacept in serum anti-citrullinated
protein antibody (ACPA)-positive patients, with increasing efficacy across ACPA
quartile levels. The aim of this study was to evaluate the cost per response
accrued using abatacept versus adalimumab in ACPA-positive and ACPA-negative
patients with RA from the health care perspective in Germany, Italy, Spain, the
US and Canada. A cost-consequence analysis (CCA) was designed to compare the
monthly costs per responding patient/patient in remission. Efficacy, safety and
resource use inputs were based on the AMPLE trial. A one-way deterministic
sensitivity analysis (OWSA) was also performed to assess the impact of model
inputs on the results for total incremental costs. Cost per response in
ACPA-positive patients favoured abatacept compared with adalimumab (ACR20, ACR90
and HAQ-DI). Subgroup analysis favoured abatacept with increasing stringency of
response criteria and serum ACPA levels. Cost per remission (DAS28-CRP) favoured
abatacept in ACPA-negative patients, while cost per CDAI and SDAI favoured
abatacept in ACPA-positive patients. Abatacept was consistently favoured in
ACPA-Q4 patients across all outcomes and countries. Cost savings were greater
with abatacept when more stringent response criteria were applied and also with
increasing ACPA levels, which could lead to a lower overall health care budget
impact with abatacept compared with adalimumab.
|*Drug Costs
[MESH]
|Abatacept/adverse effects/*economics/*therapeutic use
[MESH]
|Adalimumab/adverse effects/*economics/*therapeutic use
[MESH]
|Anti-Citrullinated Protein Antibodies/*blood
[MESH]
|Antirheumatic Agents/adverse effects/*economics/*therapeutic use
[MESH]