Budget impact model of rituximab after failure of one or more TNFα inhibitor therapies in the treatment of rheumatoid arthritis

Launois, R; Payet, Stéphanie; Saidenberg-Kermanac’h, Nathalie; Francesconi, Camille; França, Lionel Riou; Boissier, Marie‐Christophe

doi:10.1016/j.jbspin.2008.04.012

Cited by 29 publications

(26 citation statements)

References 27 publications

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“…Pharmaco-economic implications of earlier use of RTX in RA, i.e. after DMARD or one anti-TNF-agent failure, have been recently discussed [10]. Our results confirm that treatment with RTX is an effective therapy for active long-standing RA patients, allowing a good disease control in more than half of the cases.…”

Section: Discussionsupporting

confidence: 78%

Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis

Quartuccio¹,

Fabris²,

Salvin³

et al. 2009

Rheumatology

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Objectives. We explored clinical factors associated with a major response to rituximab (RTX) (e.g. ACR 550, and European League against Rheumatism (EULAR) moderate to good response) in patients with active long-standing RA and inadequate response to anti-TNF agents or traditional DMARDs. Methods. RTX was used in 110 RA patients in six different Italian centres. The mean disease activity score on 28 joints (DAS28) was 6.4 AE 0.99 and the mean HAQ was 1.63 AE 0.68 at baseline. Thirty-two patients (29.1%) underwent RTX after the failure of DMARD therapy, 37 (33.6%) had failed or were intolerant to at least two anti-TNF agents, and 41 (37.3%) had failed or were intolerant to one anti-TNF agent. Univariate and multivariate analyses were performed. Results. The number of previous anti-TNF agents (P ¼ 0.043), HAQ (P ¼ 0.023), RF positivity (P < 0.0001) and anti-cyclic citrullinated peptide (anti-CCP) positivity (P ¼ 0.003) were associated with ACR response 550 between month þ4 and month þ6 after starting RTX by univariate analysis. Multivariate analysis confirmed that a lower HAQ, a lower number of anti-TNF agents failed before RTX and RF positivity, but not anti-CCP positivity, were the selected variables associated with an ACR response 550, with an accuracy of 84% of the model. Only RF positivity correlated with EULAR moderate to good response both in the univariate and in the multivariate analysis, with an accuracy of 79% of the model. Conclusion. RF-positive rather than anti-CCP-positive RA patients with lower baseline disability and a lower number of previously failed TNF blockers may be the best candidates to RTX.

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Section: Discussionsupporting

confidence: 78%

Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis

Quartuccio¹,

Fabris²,

Salvin³

et al. 2009

Rheumatology

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“…This is mainly due to its lower drug acquisition cost. These savings could increase with the introduction of Rituximab in earlier stages of treatment [12]. Also in our model of budget impact, analysis was performed to evaluate cost implications for the Italian National Health Service (NHS) of the introduction of Rituximab (RTX) in the treatment of rheumatoid arthritis (RA).…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness treatment with Rituximab in patients with rheumatoid arthritis in real life

et al. 2010

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The cost-effectiveness of treatments that have the potential to change the "natural history" of a chronic progressive disease has to be evaluated over the long term. Cost-effectiveness estimates have been based on the concept that, with treatment, patients will not progress to the next level(s) of disease severity or will take a longer time to progress, thus avoiding or delaying the high costs and low utility associated with more severe disease. This analysis focused on the use of Rituximab in treating patients with moderate to severe RA for whom at least one anti-TNFα blocking agent had failed. The aim of our study was to evaluate the cost-effectiveness in 32 patients with rheumatoid arthritis in therapy with a single infusion of Rituximab 1,000 mg given on days 1 and 15 of each month for 1 year. After 6 months of treatment, we observed for all 32 patients a total quality-adjusted life year (QALY) gained of 11,840 with an average of 0.37 QALY for a single patient, a treatment cost of euro 5,610 and a QALY/cost ICER (incremental cost-effectiveness ratio) of euro 15,114. After 1 year of treatment, we observed data for 28 patients with a total QALY gained of 11,480 with an average of 0.41 QALY for a single patient, a treatment cost of euro 9,690 and a QALY/cost ICER (incremental cost-effectiveness ratio) of euro 23,696. The benefit of using Rituximab is cost-effectiveness with a QALY/gained under the acceptable threshold of euro 50,000 in our observational study. These are important data for discussion from the economic point of view when we choose a biologic therapy for rheumatoid arthritis in clinical practice.

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“…In particolare i pazienti FR-positivi con minore disabilità basale potrebbero ottenere maggiori vantaggi nell'utilizzo di RTX dopo un primo anti-TNFα fallito o dopo il fallimento dei DMARDs. Queste strategie terapeutiche potrebbero permettere una sostanziale riduzione di costi sanitari e sociali (11). Differenti popolazioni B-linfocitarie in grado di produrre autoanticorpi possono intervenire in diverse fasi della patogenesi dell'AR.…”

Section: Discussioneunclassified

Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNFα agents failed are associated with response to rituximab in rheumatoid arthritis

Quartuccio¹,

Salvin²,

Saracco³

et al. 2011

Reumatismo

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La presenza del fattore reumatoide, la disabilità ed il numero di precedenti anti-TNFα falliti predicono la risposta clinica a rituximab nell'artrite reumatoide * Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNFα agents failed are associated with response to rituximab in rheumatoid arthritis questo nuovo panorama la precoce identificazione di fattori predittivi di risposta clinica potrebbe guidare il Reumatologo nella scelta della terapia più efficace nel singolo paziente. Alcuni Autori infatti evidenziano come la più bassa disabilità (espressa da un ridotto HAQ) possa essere un fattore predittivo di buona risposta clinica alla terapia con anti-TNFα (1), e come la positività per anticorpi antipeptidi ciclici citrullinati (anti-CCP) e la presenza del fattore reumatoide (FR) si associno ad una malattia più aggressiva (2). Il rituximab (RTX), anticorpo monoclonale anti-CD20 in grado di colpire il braccio B linfocitario della sinovite reumatoide, è una terapia efficace e sicura nell'AR resistente ai DMARDs o agli anti-TNFα INTRODUZIONE S empre più numerosi sono i farmaci biologici disponibili per il trattamento dell'artrite reumatoide (AR) ed altrettanti sono i meccanismi patogenetici della malattia che ne vengono colpiti: in Reumatismo, 2009; 61(3):182-186 SUMMARY Objective: Predictors of response to biologics in rheumatoid arthritis (RA) is an important issue in the current era. Rituximab (RTX) has been demonstrated effective and safe in active RA

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Budget impact model of rituximab after failure of one or more TNFα inhibitor therapies in the treatment of rheumatoid arthritis

Cited by 29 publications

References 27 publications

Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis

Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis

Cost-effectiveness treatment with Rituximab in patients with rheumatoid arthritis in real life

Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNFα agents failed are associated with response to rituximab in rheumatoid arthritis

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