Dose escalation of the anti-TNF-  agents in patients with rheumatoid arthritis. A systematic review

Ariza‐Ariza, Rafael; Navarro‐Sarabia, Federico; Hernández-Cruz, B.; Rodríguez-Arboleya, L.; Navarro-Compán, Victoria; Toyos, Juan R. de los

doi:10.1093/rheumatology/kel326

Cited by 56 publications

(41 citation statements)

References 8 publications

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“…on ADA or IFX in situations of suboptimal treatment response but not for patients on ETN. [18][19][20][44][45][46][47] Dose escalation patterns obtained in the present study were similar to those reported across a number of dose escalation studies with the proportion of patients having a dose escalation being consistently and significantly lower for ETN compared with ADA and IFX. 28,29,34,35,37,39,40,42,48 Across all methods used to define dose escalation, the proportions ranged from 0.4% to 10.3%, 8.3% to 33.6%, and 16.4% to 60% for ETN, ADA, and IFX, respectively.…”

Section: Limitationssupporting

confidence: 78%

Medication Effectiveness with the Use of Tumor Necrosis Factor Inhibitors Among Texas Medicaid Patients Diagnosed with Rheumatoid Arthritis

Oladapo

Barner²,

Lawson³

et al. 2014

JMCP

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While their effectiveness has not been directly compared in a clinical trial, results from the majority of the indirect treatment comparisons suggest comparable efficacy and safety profiles. However, these TNF inhibitor agents differ in administration method and dosing flexibility, which may result in differences in medication use profiles (e.g., adherence, persistence, discontinuation, dose escalation, and switching to a new biologic rheumatoid arthritis drug) and effectiveness in clinical practice.

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Section: Limitationssupporting

confidence: 78%

Medication Effectiveness with the Use of Tumor Necrosis Factor Inhibitors Among Texas Medicaid Patients Diagnosed with Rheumatoid Arthritis

Oladapo

Barner²,

Lawson³

et al. 2014

JMCP

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“…In any case, any savings from vial sharing are dwarfed by dose escalation. 176 In the cited systematic review, 44% of patients treated with IFX had the drug dose increased.…”

Section: Estimates Of Costsmentioning

confidence: 99%

“…For ABT there was a further HAQ reduction on treatment based on an analysis of ATTAIN and an extension of RTX trials 130,176 (-0.0729 and -0.013, respectively). For all other treatments (biologic drugs and conventional DMARDs) an annual increase in HAQ score of 0.012 was assumed based on an ERG STA report on RTX (calculation was actually based on nonbiologic data).…”

Section: Estimates Of Clinical Effectiveness -Long Termmentioning

confidence: 99%

Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor inhibitor: a systematic review and economic evaluation

Malottki

Barton²,

Tsourapas³

et al. 2011

Health Technol Assess

229

150

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An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAAdalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor inhibitor: a systematic review and economic evaluation Dr Paresh Jobanputra has participated in several technology assessments/appraisals related to rheumatoid arthritis as the clinical expert of the assessment group. He works as consultant rheumatologist in a large department of rheumatology. His department has taken part in clinical trials of etanercept, adalimumab, rituximab and tocilizumab. The department receives funding for nurses from Schering-Plough Ltd to administer infliximab to patients currently being treated with this drug. Currently he is the chief investigator of a clinical trial comparing adalimumab versus etanercept (ISRCTN95861172). He has, in the past, received support for educational purposes from Wyeth Pharmaceuticals (etanercept), Abbott (adalimumab) and Roche (rituximab). He has also been involved in an advisory board for Roche in relation to tocilizumab and rituximab, and has accept...

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“…For example, an analysis of RA patients in the US showed that dose frequency was increased in ϳ40% of patients receiving infliximab (16). Dose escalation of TNF inhibitors is also relatively common internationally (17). It is unclear as to why some physicians might choose to escalate the dose of TNF inhibitors despite limited evidence to support this practice.…”

Section: Discussionmentioning

confidence: 99%

Dose escalation of certolizumab pegol from 200 mg to 400 mg every other week provides no additional efficacy in rheumatoid arthritis: An analysis of individual patient‐level data

Curtis¹,

Chen²,

Luijtens³

et al. 2011

Arthritis & Rheumatism

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Objective. To determine whether certolizumab pegol (CZP) dosage escalation from 200 mg to 400 mg every other week benefits some patients with rheumatoid arthritis (RA).Methods Results. In the group of patients who had completed the RAPID 1 study and had moderate or severe disease activity at entry into the open-label study, and in those who had been withdrawn early from the RAPID 1 study, the median DAS28 improvements 12 weeks after enrollment into the open-label study were similar in the dose-escalation and stable-dose groups. Individual patient-level data revealed no greater likelihood of response in the group of patients who received an increased dosage of CZP versus those in whom a stable dosage was maintained, whether they had completed the RAPID 1 study or had been withdrawn early.Conclusion. Although patient heterogeneity in clinical settings is acknowledged, the present results indicate that increasing the dose of CZP from 200 mg to 400 mg offers little additional benefit in RA, even for selected patients.

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Dose escalation of the anti-TNF- agents in patients with rheumatoid arthritis. A systematic review

Abstract: Dose escalation is common in patients treated with infliximab, and less frequent with etanercept. In a proportion of patients, the dose escalation seems effective. The design and evidence level of the available studies limit the strength of the conclusions.

Cited by 56 publications

References 8 publications

Medication Effectiveness with the Use of Tumor Necrosis Factor Inhibitors Among Texas Medicaid Patients Diagnosed with Rheumatoid Arthritis

Medication Effectiveness with the Use of Tumor Necrosis Factor Inhibitors Among Texas Medicaid Patients Diagnosed with Rheumatoid Arthritis

Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor inhibitor: a systematic review and economic evaluation

Dose escalation of certolizumab pegol from 200 mg to 400 mg every other week provides no additional efficacy in rheumatoid arthritis: An analysis of individual patient‐level data

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