A systematic review of effectiveness and economic evaluation of new drug treatments for juvenile idiopathic arthritis: etanercept
Cummins C, Connock M, Fry-Smith A, Burls A
Record ID 32002000835
English
Authors' objectives:
This report aims:
- To provide a background review on juvenile idiopathic arthritis (JIA), including epidemiology, current and emerging therapeutic options, and impact of disease on individuals and health services.
- To conduct a systematic review of the clinical benefits and hazards of the anti-TNF agent etanercept in JIA compared with currently available treatments.
- To review economic evidence about the cost-effectiveness of this agent compared with other treatment options.
Authors' results and conclusions:
Etanercept improves the outcomes in children and young people with JIA when compared with placebo. No comparisons between etanercept and other drugs used in this patient group were found. Other such drugs, however, are believed to have only limited efficacy in this patient group. The trial results are consistent with the results of trials of etanercept in adults with rheumatoid arthritis (RA).
Authors' recommendations:
Given the novel biological action of etanercept, long-term follow-up is desirable, and is required by regulatory agencies, in order to detect any unexpected adverse events.
There is no evidence comparing etanercept with other treatments in this patient group. Safety concerns and relative lack of efficacy would place ethical constraints on trials of relative effectiveness.
The effectiveness of etanercept in the treatment of other forms of JIA including psoriatic and enthesitis arthritis is unknown. International trials would be required, on account of the rarity of these conditions.
Greater health gains might be possible if etanercept was used earlier in the disease process and in less severe disease. Trials to test these hypotheses are required.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.hta.ac.uk/1231
Year Published:
2002
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Anti-Inflammatory Agents
- Costs and Cost Analysis
- Arthritis
Contact
Organisation Name:
NIHR Health Technology Assessment programme
Contact Address:
NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
journals.library@nihr.ac.uk
Contact Email:
journals.library@nihr.ac.uk
Copyright:
2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.