Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with TNF-α blockers
Juha Laine,1 T Sakari Jokiranta,2,3 Kari K Eklund,4,5 Merja Väkeväinen,1 Kari Puolakka6 1Pfizer Oy, Helsinki, 2United Medix Laboratories Ltd, Espoo, 3Research Programs Unit, Immunobiology, 4Department of Rheumatology, University of Helsinki, 5Helsinki University Central Hospital, Helsinki, 6Departme...
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ftdoajarticles:oai:doaj.org/article:0445bfa0021849d5b207becc33be2a18 2023-05-15T17:00:14+02:00 Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with TNF-α blockers Laine J Jokiranta TS Eklund KK Väkeväinen M Puolakka K 2016-04-01T00:00:00Z https://doaj.org/article/0445bfa0021849d5b207becc33be2a18 EN eng Dove Medical Press https://www.dovepress.com/cost-effectiveness-of-routine-measuring-of-serum-drug-concentrations-a-peer-reviewed-article-BTT https://doaj.org/toc/1177-5491 1177-5491 https://doaj.org/article/0445bfa0021849d5b207becc33be2a18 Biologics: Targets & Therapy, Vol 2016, Iss Issue 1, Pp 67-73 (2016) TNF blockers anti-drug antibodies drug concentration Medicine (General) R5-920 article 2016 ftdoajarticles 2022-12-31T08:05:06Z Juha Laine,1 T Sakari Jokiranta,2,3 Kari K Eklund,4,5 Merja Väkeväinen,1 Kari Puolakka6 1Pfizer Oy, Helsinki, 2United Medix Laboratories Ltd, Espoo, 3Research Programs Unit, Immunobiology, 4Department of Rheumatology, University of Helsinki, 5Helsinki University Central Hospital, Helsinki, 6Department of Medicine, South Karelia, Finland Abstract: Monitoring of anti-drug antibodies (ADAbs) or serum concentrations of biologicals in treatment of rheumatoid arthritis could provide an explanation for a loss of efficacy and help in the choice of subsequent medication. Current clinical practices do not generally include such monitoring of tumor necrosis factor (TNF)-α blockers on a routine basis. The main aims of this study were to estimate the probabilities of optimal and nonoptimal treatment decisions if infliximab or adalimumab drug trough level (DL) and ADAbs are tested or not in rheumatoid arthritis, and to model cost-effectiveness of performing such monitoring on a routine basis. Data on DLs and ADAbs concentrations were obtained in Finland from clinically requested monitoring analyses of 486 and 1,137 samples from patients on adalimumab and infliximab, respectively. DL was within the target range in 42% of samples from adalimumab- and 50.4% of infliximab-treated patients. ADAbs were detected in approximately 20% and 13.5% of samples from adalimumab- and infliximab-treated patients, respectively. ADAbs were found in 52.3% and 41.3% of those with low adalimumab or infliximab DLs, respectively. The monitoring data were incorporated into probabilities for making the optimal treatment decision. Economic impact of clinical decision-making was modeled in a short-term (3–6 months) scenario with 100 hypothetical patients. In the model, the combined measurement of DLs and ADAbs was cost-saving compared to the nontesting scenario when the monitoring results affected the treatment decision in at least 2–5 of 100 patients, a proportion which is easily exceeded in real-life clinical practice. This study indicates that routine ... Article in Journal/Newspaper karelia* Directory of Open Access Journals: DOAJ Articles Eklund ENVELOPE(-72.000,-72.000,-73.233,-73.233) Kari ENVELOPE(28.979,28.979,66.201,66.201) |
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topic |
TNF blockers anti-drug antibodies drug concentration Medicine (General) R5-920 |
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TNF blockers anti-drug antibodies drug concentration Medicine (General) R5-920 Laine J Jokiranta TS Eklund KK Väkeväinen M Puolakka K Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with TNF-α blockers |
topic_facet |
TNF blockers anti-drug antibodies drug concentration Medicine (General) R5-920 |
description |
Juha Laine,1 T Sakari Jokiranta,2,3 Kari K Eklund,4,5 Merja Väkeväinen,1 Kari Puolakka6 1Pfizer Oy, Helsinki, 2United Medix Laboratories Ltd, Espoo, 3Research Programs Unit, Immunobiology, 4Department of Rheumatology, University of Helsinki, 5Helsinki University Central Hospital, Helsinki, 6Department of Medicine, South Karelia, Finland Abstract: Monitoring of anti-drug antibodies (ADAbs) or serum concentrations of biologicals in treatment of rheumatoid arthritis could provide an explanation for a loss of efficacy and help in the choice of subsequent medication. Current clinical practices do not generally include such monitoring of tumor necrosis factor (TNF)-α blockers on a routine basis. The main aims of this study were to estimate the probabilities of optimal and nonoptimal treatment decisions if infliximab or adalimumab drug trough level (DL) and ADAbs are tested or not in rheumatoid arthritis, and to model cost-effectiveness of performing such monitoring on a routine basis. Data on DLs and ADAbs concentrations were obtained in Finland from clinically requested monitoring analyses of 486 and 1,137 samples from patients on adalimumab and infliximab, respectively. DL was within the target range in 42% of samples from adalimumab- and 50.4% of infliximab-treated patients. ADAbs were detected in approximately 20% and 13.5% of samples from adalimumab- and infliximab-treated patients, respectively. ADAbs were found in 52.3% and 41.3% of those with low adalimumab or infliximab DLs, respectively. The monitoring data were incorporated into probabilities for making the optimal treatment decision. Economic impact of clinical decision-making was modeled in a short-term (3–6 months) scenario with 100 hypothetical patients. In the model, the combined measurement of DLs and ADAbs was cost-saving compared to the nontesting scenario when the monitoring results affected the treatment decision in at least 2–5 of 100 patients, a proportion which is easily exceeded in real-life clinical practice. This study indicates that routine ... |
format |
Article in Journal/Newspaper |
author |
Laine J Jokiranta TS Eklund KK Väkeväinen M Puolakka K |
author_facet |
Laine J Jokiranta TS Eklund KK Väkeväinen M Puolakka K |
author_sort |
Laine J |
title |
Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with TNF-α blockers |
title_short |
Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with TNF-α blockers |
title_full |
Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with TNF-α blockers |
title_fullStr |
Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with TNF-α blockers |
title_full_unstemmed |
Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with TNF-α blockers |
title_sort |
cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibodies in treatment of rheumatoid arthritis patients with tnf-α blockers |
publisher |
Dove Medical Press |
publishDate |
2016 |
url |
https://doaj.org/article/0445bfa0021849d5b207becc33be2a18 |
long_lat |
ENVELOPE(-72.000,-72.000,-73.233,-73.233) ENVELOPE(28.979,28.979,66.201,66.201) |
geographic |
Eklund Kari |
geographic_facet |
Eklund Kari |
genre |
karelia* |
genre_facet |
karelia* |
op_source |
Biologics: Targets & Therapy, Vol 2016, Iss Issue 1, Pp 67-73 (2016) |
op_relation |
https://www.dovepress.com/cost-effectiveness-of-routine-measuring-of-serum-drug-concentrations-a-peer-reviewed-article-BTT https://doaj.org/toc/1177-5491 1177-5491 https://doaj.org/article/0445bfa0021849d5b207becc33be2a18 |
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1766052862765301760 |