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在类风湿关节炎中,更昂贵与不太昂贵的治疗策略具有相似的临床结局。来自两家风湿病诊所的观察性数据。

Similar clinical outcomes in rheumatoid arthritis with more versus less expensive treatment strategies. Observational data from two rheumatology clinics.

机构信息

Jyväskylä Central Hospital, Jyväskylä, Finland.

出版信息

Clin Exp Rheumatol. 2013 May-Jun;31(3):409-14. Epub 2013 Feb 15.

Abstract

OBJECTIVES

Selection of efficacious medications for rheumatoid arthritis (RA) has tremendously increased over a decade including new costly biologic agents and inexpensive conventional anti-rheumatic drugs, used in combinations for more efficacy. Treatments aim at remission or at least low disease activity. Our objective was to study whether treatment target is reached and to what cost, in patients with RA in two Nordic rheumatology clinics.

METHODS

Cross sectional observational clinical data of all patients with RA seen in 2010 in two Nordic county hospital rheumatology units: Kristiansand, Norway and Jyväskylä, Finland, which both serve a population of about 275,000. Measures included patient demographic measures, clinical characteristics, disease activity, functional status, and treatments. Annual costs of medications to the society were calculated per 100 patients, using an assumption that a patient is taking current medications for one year.

RESULTS

Patient populations from Kristiansand and Jyväskylä were similar according to age, gender, disease duration, and prevalence of RF and CCP. Disease activity was low and patients' functional status well reserved in both clinics. Almost twice as many patients in Kristiansand than in Jyväskylä (33% vs. 17%) used biologic agents. A combination of conventional anti-rheumatic drugs was currently used by <1% of patients in Kristiansand and by 37% of patients in Jyväskylä. Estimated annual costs of medications per 100 patients were €508,000 in Kristiansand and €280,000 in Jyväskylä.

CONCLUSIONS

Treatment target of remission/low disease activity and good functional status can be reached in RA using expensive and less-expensive anti-rheumatic drugs.

摘要

目的

在过去十年中,治疗类风湿关节炎(RA)的有效药物选择大大增加,包括新的昂贵生物制剂和廉价的常规抗风湿药物,这些药物联合使用可提高疗效。治疗的目的是缓解病情,至少是保持低疾病活动度。我们的目的是研究在两个北欧风湿病诊所的 RA 患者中,是否达到了治疗目标,以及需要付出多少成本。

方法

对 2010 年在挪威克里斯蒂安桑和芬兰于韦斯屈莱的两个北欧县立医院风湿病科就诊的所有 RA 患者进行横断面观察性临床数据分析,这两个地区的服务人群约为 275000 人。测量包括患者的人口统计学指标、临床特征、疾病活动度、功能状态和治疗情况。根据患者使用当前药物治疗一年的假设,计算每位患者每年的药物治疗社会成本。

结果

克里斯蒂安桑和于韦斯屈莱的患者人群在年龄、性别、疾病持续时间、RF 和 CCP 的患病率方面相似。两个诊所的疾病活动度均较低,患者的功能状态保持良好。在克里斯蒂安桑使用生物制剂的患者比例是于韦斯屈莱的两倍(33%比 17%)。在克里斯蒂安桑,目前使用常规抗风湿药物联合治疗的患者比例<1%,而在于韦斯屈莱这一比例为 37%。克里斯蒂安桑每位患者每年的药物治疗费用估计为 508000 欧元,于韦斯屈莱为 280000 欧元。

结论

使用昂贵和廉价的抗风湿药物,RA 患者可以达到缓解/低疾病活动度和良好功能状态的治疗目标。

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