TY - JOUR
T1 - Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System
AU - Dos Santos, Jéssica Barreto Ribeiro
AU - Almeida, Alessandra Maciel
AU - Acurcio, Francisco De Assis
AU - De Oliveira, Haliton Alves
AU - Kakehasi, Adriana Maria
AU - Guerra, Augusto Afonso
AU - Bennie, Marion
AU - Godman, Brian
AU - Alvares, Juliana
N1 - Funding Information:
AM Kakehasi has received educational grants from Abbvie, AstraZeneca, BMS, Roche, Eli-Lilly, Pfizer, Roche, Janssen, Novartis and Sanofi. This work was supported by National Council for Scientific and Technological Development, Brazil (grant number 471819/2013-1) and Fapemig, the Minas Gerais State Research Foundation, Brazil (grant number PPM-0015-15). The write-up was in part supported by a Newton Advanced Fellowship awarded to AA Guerra Jr by the Academy of Medical Sciences, through the UK Government's Newton Fund program. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Publisher Copyright:
© 2016 Future Medicine Ltd.
PY - 2016/11
Y1 - 2016/11
N2 - Aim: Biological disease-modifying antirheumatic drugs (bDMARDs) are used to treat rheumatoid arthritis (RA) with adalimumab and etanercept the most used bDMARDs in Brazil. This open prospective cohort study evaluated their effectiveness and safety among RA patients in the Brazilian Public Health System given their costs. Methods: The Clinical Disease Activity Index was primarily used to assess their effectiveness after 6 and 12 months of follow-up. The Health Assessment Questionnaire and EuroQol-5D were also used. Results: A total of 266 RA patients started treatment with adalimumab or etanercept. Adalimumab was the most widely used bDMARD (70%). In total, 46% achieved remission or low-disease activity at 12 months with no difference in effectiveness between them (p = 0.306). bDMARDs were more effective in patients who had better functionality at treatment onset and had spent longer in education. Conclusion: This real-world study demonstrated that adalimumab and etanercept are equal alternatives for RA treatment and both were well tolerated.
AB - Aim: Biological disease-modifying antirheumatic drugs (bDMARDs) are used to treat rheumatoid arthritis (RA) with adalimumab and etanercept the most used bDMARDs in Brazil. This open prospective cohort study evaluated their effectiveness and safety among RA patients in the Brazilian Public Health System given their costs. Methods: The Clinical Disease Activity Index was primarily used to assess their effectiveness after 6 and 12 months of follow-up. The Health Assessment Questionnaire and EuroQol-5D were also used. Results: A total of 266 RA patients started treatment with adalimumab or etanercept. Adalimumab was the most widely used bDMARD (70%). In total, 46% achieved remission or low-disease activity at 12 months with no difference in effectiveness between them (p = 0.306). bDMARDs were more effective in patients who had better functionality at treatment onset and had spent longer in education. Conclusion: This real-world study demonstrated that adalimumab and etanercept are equal alternatives for RA treatment and both were well tolerated.
KW - Brazil
KW - adalimumab
KW - cohort study
KW - effectiveness
KW - etanercept
KW - rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=84992154422&partnerID=8YFLogxK
U2 - 10.2217/cer-2016-0027
DO - 10.2217/cer-2016-0027
M3 - Article
C2 - 27641309
AN - SCOPUS:84992154422
SN - 2042-6305
VL - 5
SP - 539
EP - 549
JO - Journal of Comparative Effectiveness Research
JF - Journal of Comparative Effectiveness Research
IS - 6
ER -