Authors' objectives:

This report reviews the evidence for the clinical effectiveness and cost-effectiveness of etanercept and infliximab, agents that inhibit tumour necrosis factor alpha (TNFa) when used in the treatment of rheumatoid arthritis (RA) in adults and referred to as anti-TNFs.

Authors' recommendations: Further research and development of economic models is necessary to reflect clinical practice more accurately. Future models need to include other aspects of RA, such as disease complications, to improve current models. Comparative studies of anti-TNF agents and other DMARDs (new and old) should be carried out, as only one study included in this review compared anti-TNF directly with another DMARD. This showed equivalent efficacy. Such direct comparisons have a potential for informing practice, especially where therapeutic choices that take cost into account are to be made. Studies of the quality of life of RA patients in the long term and the impact of DMARDs and other interventions on quality of life are needed. Also needed are studies of the impact of DMARDs on joint replacement, and other disease and drug-related morbidity, and on mortality.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.hta.ac.uk/1219

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

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