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Etanercept and infliximab for the treatment of psoriatic arthritis: a systematic review and economic evaluation |
Woolacott N, Bravo Vergel Y, Hawkins N, Kainth A, Khadjesari Z, Misso K, Light K, Asseburg C, Palmer S, Claxton K, Bruce I, Sculpher M, Riemsma R |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Woolacott N, Bravo Vergel Y, Hawkins N, Kainth A, Khadjesari Z, Misso K, Light K, Asseburg C, Palmer S, Claxton K, Bruce I, Sculpher M, Riemsma R. Etanercept and infliximab for the treatment of psoriatic arthritis: a systematic review and economic evaluation. Health Technology Assessment 2006; 10(31): 1-258 Authors' objectives The aim of this review was to evaluate the clinical effectiveness, safety, tolerability and cost-effectiveness of etanercept and infliximab for the treatment of active and progressive psoriatic arthritis (PsA) in patients who have inadequate response to standard treatment, including disease-modifying antirheumatic drug (DMARD) therapy.
Authors' conclusions The limited data available indicated that etanercept and infliximab are efficacious in the treatment of PsA with beneficial effects on both joint and psoriasis symptoms and on functional status. Short-term data indicated that etanercept can delay joint disease progression, but long-term data are needed. There are no controlled data as yet to indicate that infliximab can delay joint disease progression. Treatment with both etanercept and infliximab for 12 weeks demonstrated a significant degree of efficacy, with no statistically significant difference between them. For both drugs, adverse events were common with mild injection/infusion reactions being the main treatment-related effect. The York model indicated that etanercept is more cost-effective than infliximab as it has a lower cost with little difference in outcomes. The cost-effectiveness of etanercept is also sensitive to assumptions made about the extent of disease progression when patients are responding to therapy. The number of years for which a patient can be safely on biologicals is uncertain so these results should be considered with caution. Further research should include long-term controlled trials to confirm benefits, review adverse events and to explore further the implications of biologic therapy.
INAHTA brief and checklist Indexing Status Subject indexing assigned by CRD MeSH Anti-Inflammatory Agents, Non-Steroidal /therapeutic use; Antibodies, Monoclonal /therapeutic use; Antirheumatic Agents /therapeutic use; Arthritis, Psoriatic /drug therapy /therapeutic use; Immunoglobulin G /therapeutic use; Isoxazoles /therapeutic use; Receptors, Tumor Necrosis Factor /therapeutic use; Tumor Necrosis Factor-alpha /antagonists & inhibitors Language Published English Country of organisation England Address for correspondence NETSCC, Health Technology Assessment, Alpha House, University of Southampton Science Park, Southampton, SO16 7NS UK Tel: +44 23 8059 5586 Email: hta@hta.ac.uk AccessionNumber 32006000963 Date bibliographic record published 09/10/2006 Date abstract record published 09/10/2006 |
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