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@article{1344296,
author = {Zavada, J. and Uher, Michal and Sisol, K. and Forejtova, S. and Jarosova, K. and Mann, H. and Vencovsky, J. and Pavelka, K.},
article_location = {London},
article_number = {1},
doi = {http://dx.doi.org/10.1136/annrheumdis-2014-205202},
keywords = {RADIOGRAPHIC PROGRESSION; INFLIXIMAB REMICADE(R); RHEUMATOID-ARTHRITIS; IMPORTANT DIFFERENCE; ETANERCEPT; THERAPY; TRIAL},
language = {eng},
issn = {0003-4967},
journal = {Annals of the Rheumatic Diseases},
title = {A tailored approach to reduce dose of anti-TNF drugs may be equally effective, but substantially less costly than standard dosing in patients with ankylosing spondylitis over 1 year: a propensity score-matched cohort study},
volume = {75},
year = {2016}
}
TY - JOUR
ID - 1344296
AU - Zavada, J. - Uher, Michal - Sisol, K. - Forejtova, S. - Jarosova, K. - Mann, H. - Vencovsky, J. - Pavelka, K.
PY - 2016
TI - A tailored approach to reduce dose of anti-TNF drugs may be equally effective, but substantially less costly than standard dosing in patients with ankylosing spondylitis over 1 year: a propensity score-matched cohort study
JF - Annals of the Rheumatic Diseases
VL - 75
IS - 1
SP - 96-102
EP - 96-102
PB - BMI Journals
SN - 00034967
KW - RADIOGRAPHIC PROGRESSION
KW - INFLIXIMAB REMICADE(R)
KW - RHEUMATOID-ARTHRITIS
KW - IMPORTANT DIFFERENCE
KW - ETANERCEPT
KW - THERAPY
KW - TRIAL
N2 - Objective To compare the effectiveness, safety and costs of standard versus individually tailored reduced doses of anti-tumour necrosis factor (TNF) drugs in patients with ankylosing spondylitis (AS) after achieving low-disease activity. Methods This was a single-centre prospective observational study performed within the ATTRA registry. The anti-TNF dose tapering strategy was chosen by treating physicians, without prespecified protocol. We used propensity score (PS) methodology to identify two cohorts of patients matched for relevant baseline characteristics who were treated with either reduced (n=53) or standard (n=83) doses of TNF inhibitors. One-year outcomes and costs of anti-TNF drugs were compared between both PS-matched cohorts. Results In the reduced dosing group, the median dose of TNF inhibitor corresponded to 0.67 and 0.5 of the standard dose initially and at 12 months respectively, and 21% of patients required return to standard dosing regimen. The mean change per year in Bath Ankylosing Spondylitis Activity Index, C-reactive protein, Health Assessment Questionnaire Disability Index and Bath AS functional index, as well as quality-adjusted life-year area under the curve were no different between both groups. The HR (95% CI) of reduced versus standard dosing group for relapse and any adverse event was 1.46 (0.66 to 3.19) and 0.56 (0.22 to 1.44), respectively. Mean difference (95% CI) in cost of anti-TNF drugs was (sic)-4214 (-4707 to -3701) per year of treatment in favour of reduced dosing strategy. Conclusions In patients with AS after reaching low-disease activity, a tailored approach to reduce doses of anti-TNF drugs produced similar clinical outcomes at 1 year, but was substantially less costly.
ER -
ZAVADA, J., Michal UHER, K. SISOL, S. FOREJTOVA, K. JAROSOVA, H. MANN, J. VENCOVSKY a K. PAVELKA. A tailored approach to reduce dose of anti-TNF drugs may be equally effective, but substantially less costly than standard dosing in patients with ankylosing spondylitis over 1 year: a propensity score-matched cohort study. \textit{Annals of the Rheumatic Diseases}. London: BMI Journals, 2016, roč.~75, č.~1, s.~96-102. ISSN~0003-4967. Dostupné z: https://dx.doi.org/10.1136/annrheumdis-2014-205202.
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