Athanasakis Kostas, Petrakis Ioannis, Kyriopoulos John
Department of Health Economics, National School of Public Health, 196 Alexandras Avenue, 11521 Athens, Greece.
ISRN Rheumatol. 2013 May 30;2013:256871. doi: 10.1155/2013/256871. Print 2013.
Background. Rheumatoid arthritis is a progressive inflammatory disease that affects greatly patients' quality of life and demands for aggressive management early on during the course of the disease. The discovery of biologics has equipped rheumatologists with evolutionary treatment tools but has also impacted greatly management costs. Objectives. To conduct a systematic review in order to evaluate the cost effectiveness of abatacept in the treatment of moderate to severe rheumatoid arthritis. Methods. Pubmed, the International Society for Pharmacoeconomics and Outcomes Research Outcomes Research Digest, the National Health System Economic Evaluation Database, and the Database of Abstracts of Reviews of Effects were searched. Results. In total 301 studies were identified and 42 met the inclusion criteria. Half of the selected studies evaluated abatacept in the treatment of rheumatoid arthritis, after failure of or intolerance to tumor necrosis factor alpha inhibitors. Of those, 82% were in favor of abatacept as a cost-effective or dominant strategy versus varying alternatives, whereas 18% favored other treatments. Conclusion. The majority of evidence from the published literature supports that abatacept can be a cost-effective alternative in the treatment of moderate to severe rheumatoid arthritis, especially in patients that have demonstrated inadequate response or intolerance to anti-TNF agents or conventional disease modifying antirheumatic drugs.
背景。类风湿性关节炎是一种进行性炎症性疾病，极大地影响患者的生活质量，需要在疾病过程早期进行积极管理。生物制剂的发现为风湿病学家提供了革命性的治疗工具，但也极大地影响了管理成本。目的。进行一项系统评价，以评估阿巴西普治疗中重度类风湿性关节炎的成本效益。方法。检索了PubMed、国际药物经济学和结果研究学会结果研究文摘、国家卫生系统经济评价数据库以及循证医学数据库。结果。共识别出301项研究，42项符合纳入标准。所选研究中有一半评估了阿巴西普在肿瘤坏死因子α抑制剂治疗失败或不耐受后用于治疗类风湿性关节炎的情况。其中，82%的研究支持阿巴西普作为一种具有成本效益或主导性的策略，优于各种替代方案，而18%的研究支持其他治疗方法。结论。已发表文献中的大多数证据支持，阿巴西普在治疗中重度类风湿性关节炎方面可能是一种具有成本效益的替代方案，尤其是在对抗肿瘤坏死因子药物或传统改善病情抗风湿药物反应不足或不耐受的患者中。
