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Long-term efficacy and cost-effectiveness of infliximab as first-line treatment in rheumatoid arthritis: systematic review and meta-analysis

Zrubka, Zsombor and Gulácsi, László and Brodszky, Valentin and Rencz, Fanni and Alten, Rieke and Szekanecz, Zoltán and Péntek, Márta (2019) Long-term efficacy and cost-effectiveness of infliximab as first-line treatment in rheumatoid arthritis: systematic review and meta-analysis. Expert Review of Pharmacoeconomics & Outcomes Research, 19 (5). pp. 537-549. DOI https://doi.org/10.1080/14737167.2019.1647104

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Official URL: https://doi.org/10.1080/14737167.2019.1647104

A nyílt hozzáférést az EISZ és a kiadó között létrejött "Read and Publish" szerződés biztosította. Open access was provided "Read and Publish" contract between EIS and the publisher.

Abstract

Introduction: Early biological treatment of rheumatoid arthritis (RA) may reverse the autoimmune response in some patients resulting in favorable long-term outcomes. Although the cost-effectiveness of this strategy has been questioned, biosimilar entries warrant the revision of clinical and pharmaco-economic evidence. Areas covered: We conducted a systematic review of randomized controlled trials (RCTs) published up to 24 May 2018 in Pubmed, EMBASE and Cochrane CENTRAL, comparing infliximab with non-biological therapy in patients with RA naïve to methotrexate. We performed meta-analyses for efficacy outcomes at month 6 and years 1 and 2. Six RCTs were identified, involving 1832 patients. At month 6 ACR70 response and remission, and at year 1 ACR20/ACR70 responses and remission were improved significantly with first-line infliximab versus control. The differences were not significant at year 2. We reviewed cost-utility studies, up to 31 October 2018 in PubMed, Cochrane CENTRAL and the CRD HTA databases. Four studies indicated that first-line use of originator infliximab calculated at 2005–2008 prices was not cost-effective. Expert opinion: We demonstrated the efficacy benefits of first-line infliximab therapy up to 1 year in methotrexate-naïve RA. We highlighted the need for standardized reporting of outcomes and conducting cost-effectiveness analyses of first-line biosimilar therapy in RA.

Item Type:Article
Uncontrolled Keywords:biosimilar, cost-utility analysis, efficacy, infliximab, meta-analysis, early rheumatoid arthritis
Subjects:Social welfare, insurance, health care
DOI:https://doi.org/10.1080/14737167.2019.1647104
ID Code:5628
Deposited By: Veronika Vitéz
Deposited On:23 Apr 2020 13:02
Last Modified:23 Apr 2020 13:02

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