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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ftdovepress:oai:dovepress.com/26258 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,Juha Jokiranta,Sakari Eklund,Kari Väkeväinen,Merja Puolakka,Kari 2016-04-01 text/html https://www.dovepress.com/cost-effectiveness-of-routine-measuring-of-serum-drug-concentrations-a-peer-reviewed-fulltext-article-BTT en eng Dove Press info:eu-repo/semantics/altIdentifier/doi/10.2147/BTT.S96982 https://www.dovepress.com/cost-effectiveness-of-routine-measuring-of-serum-drug-concentrations-a-peer-reviewed-fulltext-article-BTT info:eu-repo/semantics/openAccess Biologics: Targets and Therapy Original Research info:eu-repo/semantics/article 2016 ftdovepress https://doi.org/10.2147/BTT.S96982 2022-12-27T22:00:22Z 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* Dove Medical Press Kari ENVELOPE(28.979,28.979,66.201,66.201) Eklund ENVELOPE(-72.000,-72.000,-73.233,-73.233) Biologics: Targets and Therapy 67 |
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Biologics: Targets and Therapy Laine,Juha Jokiranta,Sakari Eklund,Kari Väkeväinen,Merja Puolakka,Kari 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 |
Biologics: Targets and Therapy |
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,Juha Jokiranta,Sakari Eklund,Kari Väkeväinen,Merja Puolakka,Kari |
author_facet |
Laine,Juha Jokiranta,Sakari Eklund,Kari Väkeväinen,Merja Puolakka,Kari |
author_sort |
Laine,Juha |
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 Press |
publishDate |
2016 |
url |
https://www.dovepress.com/cost-effectiveness-of-routine-measuring-of-serum-drug-concentrations-a-peer-reviewed-fulltext-article-BTT |
long_lat |
ENVELOPE(28.979,28.979,66.201,66.201) ENVELOPE(-72.000,-72.000,-73.233,-73.233) |
geographic |
Kari Eklund |
geographic_facet |
Kari Eklund |
genre |
karelia* |
genre_facet |
karelia* |
op_relation |
info:eu-repo/semantics/altIdentifier/doi/10.2147/BTT.S96982 https://www.dovepress.com/cost-effectiveness-of-routine-measuring-of-serum-drug-concentrations-a-peer-reviewed-fulltext-article-BTT |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.2147/BTT.S96982 |
container_title |
Biologics: Targets and Therapy |
container_start_page |
67 |
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1766052862168662016 |