Clinical and economic impact of the use of etanercept 25 mg once weekly in rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis patients

Borrás-Blasco, Joaquı́n; Gracia-Pérez, Antonio; Rosique-Robles, J Dolores; Mora, Elvira; Abad, F Javier

doi:10.1517/14712598.2014.868433

Cited by 18 publications

(11 citation statements)

References 17 publications

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“…Following the literature search and screening process, 10 studies published in 11 full-text publications [ 12 – 22 ] qualified for inclusion (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Four observational studies evaluated dosing down a TNF inhibitor in patients with RA (Table 2 ). A retrospective observational study by Borrás-Blasco et al [ 12 ] evaluated patients who had achieved and maintained DAS28 <2.6 for at least 1 year on ETN50 qw and then were switched to ETN25 qw. At study end, 17 of 24 patients were continuing ETN25; the median treatment duration was 3.5 ± 2.5 years.…”

Section: Resultsmentioning

confidence: 99%

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Down-titration of biologics for the treatment of rheumatoid arthritis: a systematic literature review

et al. 2017

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Biologic therapies have improved the management of rheumatoid arthritis (RA) and the treat-to-target approach has resulted in many patients achieving remission. In the current treatment landscape, clinicians have begun considering dose reduction/tapering for their patients. Rheumatology guidelines in Asia, Europe, and the United States include down-titration of biologics but admit that the level of evidence is moderate. We conducted a systematic literature review to assess the published studies that evaluate down-titration of biologics in RA. The published literature was searched for studies that down-titrated the following biologics: abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, and tocilizumab. Eligible studies included randomized controlled trials (RCTs), non-RCTs, observational, and pharmacoeconomic studies. The outcomes of interest were (1) efficacy and health-related quality of life, (2) disease flares, and (3) impact on cost. Eleven full-text publications were identified; only three were RCTs. Study results suggest that dosing down may be an option in many patients who have achieved remission or low disease activity. However, some patients are likely to experience a disease flare. Across the studies, the definition of disease flare and the down-titration criteria were inconsistent, making it difficult to conclude which patients may be appropriate and when to attempt down-titration. Studies have evaluated the practice of dosing down biologic therapy in patients with RA; however, a relatively small number of RCTs have been published. Although down-titration may be an option for some patients in LDA or remission, additional RCTs are needed to provide guidance on this practice.Electronic supplementary materialThe online version of this article (doi:10.1007/s00296-017-3780-8) contains supplementary material, which is available to authorized users.

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“…Following the literature search and screening process, 10 studies published in 11 full-text publications [ 12 – 22 ] qualified for inclusion (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Down-titration of biologics for the treatment of rheumatoid arthritis: a systematic literature review

et al. 2017

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“…At June 1, 2013, 29 (74%) patients continued on ETN25 (17 with RA, 4 with PA and 8 with AS). In RA patients: 17 patients continued on ETN25, 5 patients discontinued use due to reactivation of RA (4 switched back to ETN50 and 1 switched to ADA; all regained clinical remission) and 2 patients discontinued use due to adverse reactions [32]. Borras-Blasco et al also studied with the same methodology, the dose reduction in 7 ADA RA patients.…”

Section: Dose Reductionsmentioning

confidence: 99%

Dose modification of anti-TNF in rheumatoid arthritis and estimated economical impact: a review of observational studies

Borrás-Blasco¹,

Ruíz²

2015

Expert Review of Pharmacoeconomics & Outcomes Research

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Anti-TNF drugs indicated for the treatment of moderate-to-severe active rheumatoid arthritis (RA) presents similar efficacy, safety and potential toxicity profiles, with more than 10 years' treatment experience. Several pharmacoeconomic evaluations had demonstrated their favorable cost-effectiveness profile in RA patients, based on pivotal clinical studies data from different countries and perspectives. However, in clinical practice, individual profiles of patients and drugs leads to dose modifications that may be associated with substantial cost deviations. Here, we further discuss the effect of dose titration of these biological drugs in clinical practice over their RA cost-effectiveness profiles.

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“…Although complete discontinuation of anti-TNFα therapy in axial SpA patients who are in remission cannot be generally recommended due to a high risk of a flare, a dose reduction or increase of the time interval between injections / infusions might be a reliable option for some patients in order to decrease risks related to therapy and to minimize costs [41]. Such an approach is being used by some rheumatologists in clinical practice, but many questions remain open, i.e., how long should remission sustain prior to start of the dose reduction / interval increase, what are predictors of non-relapse, what are the steps in the reduction of the dose or injection interval increase.…”

Section: Rates Of the Drug-induced And Drug-free Remission In Axiamentioning

confidence: 99%

Spontaneous, drug-induced, and drug-free remission in peripheral and axial spondyloarthritis

Poddubnyy

Gensler

2014

Best Practice & Research Clinical Rheumatology

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In Spondyloarthritis (SpA), spontaneous remission is best described in Reactive Arthritis, a form of peripheral SpA. Prior SpA observational studies suggested a significant percent of patient reached spontaneous remission; however, these patients were followed under older, broader European Spondyloarthropathy Study Group (ESSG) criteria or were not defined by specific criteria. In general they were mixed populations of peripheral and axial disease and subsets were not differentiated when assessing endpoints like remission. There is limited data on the natural history of axial SpA, in part because of the evolution of the criteria with the more recently developed Assessment of SpondyloArthritis international Society (ASAS) criteria, including the designation of non-radiographic Axial SpA and peripheral SpA. Clinical trials have been done with various remission endpoints including withdrawal of therapy to determine remission maintenance. The following review will address the potential for remission in axial and peripheral SpA based on the data from both observational studies and clinical trials.

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Clinical and economic impact of the use of etanercept 25 mg once weekly in rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis patients

Cited by 18 publications

References 17 publications

Down-titration of biologics for the treatment of rheumatoid arthritis: a systematic literature review

Down-titration of biologics for the treatment of rheumatoid arthritis: a systematic literature review

Dose modification of anti-TNF in rheumatoid arthritis and estimated economical impact: a review of observational studies

Spontaneous, drug-induced, and drug-free remission in peripheral and axial spondyloarthritis

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