RESEARCH - Humira and Enbrel edge Remicade in RA therapy

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Adalimumab and Etanercept Edge Infliximab in RA Therapy

NEW YORK (Reuters Health) Sept 17 - Among tumor necrosis factor alpha

blockers, adalimumab and etanercept appear to be more effective and

less expensive than infliximab for treatment of patients with

rheumatoid arthritis (RA), Dutch researchers report in the September

issue of ls of the Rheumatic Diseases.

Dr. Wietske Kievit of Radboud University Nijmegen Medical Centre and

colleagues came to this conclusion after studying prospectively

gathered clinical practice data on 707 patients who were followed for

at least 1 year; 38% started with adalimumab, 41% with etanercept, and

the remaining 21% with infliximab.

Over the 12 months of follow-up, Disease Activity Score (DAS28) and

the Short-Form 36 score fell in all groups, but the reduction was

significantly greater with adalimumab or etanercept than with

infliximab. Other instruments indicated a trend towards improved

functionality and quality of life in the adalimumab and etanercept

groups.

The team also found a significant difference between adalimumab and

etanercept in DAS28 score, with adalimumab having the advantage.

However, there were no significant differences in other measures.

Furthermore, median costs for infliximab (14,220 euros) were

significantly greater than for adalimumab (13,871 euros) and

etanercept (13,938 euros). This was also true of total RA medication

costs per group.

The researchers observe that adalimumab and etanercept are essentially

comparable, and Dr. Kievit told Reuters Health that overall,

evaluation of effectiveness and costs " revealed better outcomes than

infliximab in the first year of treatment. "

" Future research, " she concluded, " should consider whether a different

dosing scheme for infliximab -- higher doses or shorter intervals --

is equally effective in daily clinical practice as adalimumab or

etanercept. "

Ann Rheum Dis 2008;67:1229-1234.

http://www.medscape.com/viewarticle/580702

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