Maarten Boers, MSc, MD, PhD
Potential Conflicts of Interest:Consultancies: M. Boers (Roche, Nitec, Mapi Values, GlaxoSmithKline). Honoraria: M. Boers (Sanofi, Novartis, Merck, Astra, Nicox, Savient, Combinatorx, Astellas MedImmune, Schering-Plough).
Requests for Single Reprints: Maarten Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, VU University Medical Center, PK 6Z 185, Box 7057, 1007 MB, Amsterdam, the Netherlands; e-mail, firstname.lastname@example.org.
Boers M. Cost-Effectiveness of Biologics as First-Line Treatment of Rheumatoid Arthritis: Case Closed?. Ann Intern Med. 2009;151:668-669. doi: 10.7326/0003-4819-151-9-200911030-00013
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Published: Ann Intern Med. 2009;151(9):668-669.
Rheumatoid arthritis (RA) is an autoimmune, multisystem disease characterized by chronic inflammation and, ultimately, destruction of joints. Left unchecked, it leads to a high burden of disease, early loss of work capacity, major morbidity, and increased mortality. The concept of a window of opportunity—that early and aggressive treatment could prevent many of the long-term consequences of the disease—was introduced in the early 1990s (1). The drugs available at that time, including disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids, were tested in different combination strategies and proven through tight-control strategies to be effective in both the short and the long term. Treatment of RA received a subsequent boost from the introduction of new biologic therapies, beginning with tumor necrosis factor (TNF)-α inhibitors and recently followed by agents that modulate other targets. With 1 exception, all have shown great efficacy that matches that of optimum conventional combination therapies, as well as a good safety profile and ease of use.
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Rheumatology, Healthcare Delivery and Policy, Rheumatoid Arthritis.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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