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Biologics Effective, but Pricy, to Treat Juvenile Arthritis

Patients who do not respond to methotrexate may benefit from biologic drugs

MONDAY, Jan. 24 (HealthDay News) -- Biologics are more effective than methotrexate (MTX) in achieving a short-term response in patients with juvenile idiopathic arthritis (JIA) who have had previous suboptimal response to disease-modifying antirheumatic drugs, according to research published in the January issue of Arthritis Care & Research.

Wendy J. Ungar, Ph.D., of the University of Toronto, and colleagues conducted a cost-effective analysis to weigh the additional treatment costs of a biologic drug versus MTX against additional effectiveness. They reviewed randomized controlled trials that evaluated etanercept, adalimumab, abatacept, and infliximab for the treatment of polyarticular-course JIA after suboptimal response or intolerance to MTX. Effectiveness was measured by the proportion of patients who responded to treatment at one year according to the American College of Rheumatology (ACR) Pediatric 30 (Pedi 30) improvement criteria.

The researchers found that in the base-case scenarios, every biologic was more costly, but also more effective than the MTX comparator. The additional costs per additional ACR Pedi 30 responder at one year were $26,061 for etanercept, $46,711 for adalimumab, $16,204 for abatacept, and $31,209 for infliximab.

"The current evidence shows a short-term improvement in disease status following treatment with biologics in patients with polyarticular JIA who previously had an inadequate response to conventional treatment, albeit at a high annual cost," the authors write.

One author disclosed involvement with the data safety monitoring board for Novartis.

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