-
Je něco špatně v tomto záznamu ?
A tailored approach to reduce dose of anti-TNF drugs may be equally effective, but substantially less costly than standard dosing in patients with ankylosing spondylitis over 1 year: a propensity score-matched cohort study
J. Závada, M. Uher, K. Sisol, Š. Forejtová, K. Jarošová, H. Mann, J. Vencovský, K. Pavelka,
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu srovnávací studie, časopisecké články, pozorovací studie, práce podpořená grantem
Health & Medicine (ProQuest) od 1939-01-01 do Před 6 měsíci
Family Health Database (ProQuest) od 1939-01-01 do Před 6 měsíci
Odkazy
PubMed
25165033
DOI
10.1136/annrheumdis-2014-205202
Knihovny.cz E-zdroje
- MeSH
- adalimumab aplikace a dávkování ekonomika MeSH
- ankylózující spondylitida farmakoterapie ekonomika MeSH
- antirevmatika aplikace a dávkování ekonomika MeSH
- C-reaktivní protein metabolismus MeSH
- časové faktory MeSH
- dospělí MeSH
- etanercept aplikace a dávkování ekonomika MeSH
- infliximab aplikace a dávkování ekonomika MeSH
- kvalitativně upravené roky života MeSH
- lidé středního věku MeSH
- lidé MeSH
- náklady na léky MeSH
- následné studie MeSH
- plocha pod křivkou MeSH
- posuzování pracovní neschopnosti MeSH
- přežití po terapii bez příznaků nemoci MeSH
- prospektivní studie MeSH
- recidiva MeSH
- stupeň závažnosti nemoci MeSH
- tendenční skóre MeSH
- TNF-alfa antagonisté a inhibitory MeSH
- udržovací chemoterapie ekonomika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: To compare the effectiveness, safety and costs of standard versus individually tailored reduced doses of anti-tumour necrosis factor (TNF) drugs in patients with ankylosing spondylitis (AS) after achieving low-disease activity. METHODS: This was a single-centre prospective observational study performed within the ATTRA registry. The anti-TNF dose tapering strategy was chosen by treating physicians, without prespecified protocol. We used propensity score (PS) methodology to identify two cohorts of patients matched for relevant baseline characteristics who were treated with either reduced (n=53) or standard (n=83) doses of TNF inhibitors. One-year outcomes and costs of anti-TNF drugs were compared between both PS-matched cohorts. RESULTS: In the reduced dosing group, the median dose of TNF inhibitor corresponded to 0.67 and 0.5 of the standard dose initially and at 12 months respectively, and 21% of patients required return to standard dosing regimen. The mean change per year in Bath Ankylosing Spondylitis Activity Index, C-reactive protein , Health Assessment Questionnaire Disability Index and Bath AS functional index, as well as quality-adjusted life-year area under the curve were no different between both groups. The HR (95% CI) of reduced versus standard dosing group for relapse and any adverse event was 1.46 (0.66 to 3.19) and 0.56 (0.22 to 1.44), respectively. Mean difference (95% CI) in cost of anti-TNF drugs was €-4214 (-4707 to -3701) per year of treatment in favour of reduced dosing strategy. CONCLUSIONS: In patients with AS after reaching low-disease activity, a tailored approach to reduce doses of anti-TNF drugs produced similar clinical outcomes at 1 year, but was substantially less costly.
- 000
- 00000naa a2200000 a 4500
- 001
- bmc16021067
- 003
- CZ-PrNML
- 005
- 20200206074417.0
- 007
- ta
- 008
- 160722s2016 enk f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1136/annrheumdis-2014-205202 $2 doi
- 024 7_
- $a 10.1136/annrheumdis-2014-205202 $2 doi
- 035 __
- $a (PubMed)25165033
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a enk
- 100 1_
- $a Závada, Jakub $u Institute of Rheumatology and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- 245 12
- $a A tailored approach to reduce dose of anti-TNF drugs may be equally effective, but substantially less costly than standard dosing in patients with ankylosing spondylitis over 1 year: a propensity score-matched cohort study / $c J. Závada, M. Uher, K. Sisol, Š. Forejtová, K. Jarošová, H. Mann, J. Vencovský, K. Pavelka,
- 520 9_
- $a OBJECTIVE: To compare the effectiveness, safety and costs of standard versus individually tailored reduced doses of anti-tumour necrosis factor (TNF) drugs in patients with ankylosing spondylitis (AS) after achieving low-disease activity. METHODS: This was a single-centre prospective observational study performed within the ATTRA registry. The anti-TNF dose tapering strategy was chosen by treating physicians, without prespecified protocol. We used propensity score (PS) methodology to identify two cohorts of patients matched for relevant baseline characteristics who were treated with either reduced (n=53) or standard (n=83) doses of TNF inhibitors. One-year outcomes and costs of anti-TNF drugs were compared between both PS-matched cohorts. RESULTS: In the reduced dosing group, the median dose of TNF inhibitor corresponded to 0.67 and 0.5 of the standard dose initially and at 12 months respectively, and 21% of patients required return to standard dosing regimen. The mean change per year in Bath Ankylosing Spondylitis Activity Index, C-reactive protein , Health Assessment Questionnaire Disability Index and Bath AS functional index, as well as quality-adjusted life-year area under the curve were no different between both groups. The HR (95% CI) of reduced versus standard dosing group for relapse and any adverse event was 1.46 (0.66 to 3.19) and 0.56 (0.22 to 1.44), respectively. Mean difference (95% CI) in cost of anti-TNF drugs was €-4214 (-4707 to -3701) per year of treatment in favour of reduced dosing strategy. CONCLUSIONS: In patients with AS after reaching low-disease activity, a tailored approach to reduce doses of anti-TNF drugs produced similar clinical outcomes at 1 year, but was substantially less costly.
- 650 _2
- $a adalimumab $x aplikace a dávkování $x ekonomika $7 D000068879
- 650 _2
- $a dospělí $7 D000328
- 650 _2
- $a antirevmatika $x aplikace a dávkování $x ekonomika $7 D018501
- 650 _2
- $a plocha pod křivkou $7 D019540
- 650 _2
- $a C-reaktivní protein $x metabolismus $7 D002097
- 650 _2
- $a posuzování pracovní neschopnosti $7 D004185
- 650 _2
- $a přežití po terapii bez příznaků nemoci $7 D018572
- 650 _2
- $a náklady na léky $7 D016527
- 650 _2
- $a etanercept $x aplikace a dávkování $x ekonomika $7 D000068800
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a následné studie $7 D005500
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a infliximab $x aplikace a dávkování $x ekonomika $7 D000069285
- 650 _2
- $a udržovací chemoterapie $x ekonomika $7 D060046
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 _2
- $a lidé středního věku $7 D008875
- 650 _2
- $a tendenční skóre $7 D057216
- 650 _2
- $a prospektivní studie $7 D011446
- 650 _2
- $a kvalitativně upravené roky života $7 D019057
- 650 _2
- $a recidiva $7 D012008
- 650 _2
- $a stupeň závažnosti nemoci $7 D012720
- 650 _2
- $a ankylózující spondylitida $x farmakoterapie $x ekonomika $7 D013167
- 650 _2
- $a časové faktory $7 D013997
- 650 _2
- $a TNF-alfa $x antagonisté a inhibitory $7 D014409
- 651 _2
- $a Česká republika $7 D018153
- 655 _2
- $a srovnávací studie $7 D003160
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a pozorovací studie $7 D064888
- 655 _2
- $a práce podpořená grantem $7 D013485
- 700 1_
- $a Uher, Michal $u Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
- 700 1_
- $a Sisol, Katarína $u Institute of Rheumatology and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- 700 1_
- $a Forejtová, Šárka $u Institute of Rheumatology and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- 700 1_
- $a Jarošová, Kateřina $u Institute of Rheumatology and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- 700 1_
- $a Mann, Heřman, $d 1973- $7 nlk20010095506 $u Institute of Rheumatology and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- 700 1_
- $a Vencovský, Jiří $u Institute of Rheumatology and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- 700 1_
- $a Pavelka, Karel $u Institute of Rheumatology and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- 773 0_
- $w MED00000444 $t Annals of the rheumatic diseases $x 1468-2060 $g Roč. 75, č. 1 (2016), s. 96-102
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/25165033 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y a $z 0
- 990 __
- $a 20160722 $b ABA008
- 991 __
- $a 20200206074805 $b ABA008
- 999 __
- $a ok $b bmc $g 1155737 $s 945595
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2016 $b 75 $c 1 $d 96-102 $e 20140827 $i 1468-2060 $m Annals of the rheumatic diseases $n Ann Rheum Dis $x MED00000444
- LZP __
- $a Pubmed-20160722