Limited evidence prevents firm conclusions on rheumatoid arthritis drug therapies
A newly updated research review from the Effective
Health Care Program of the Agency for Healthcare
Research and Quality (AHRQ) reinforces the current
standards of care for drug therapies used to treat
rheumatoid arthritis (RA). The review concluded that
there is not enough evidence to determine which
individual oral disease-modifying antirheumatic drug
(DMARD) or combination therapy is best. Overall
tolerability is similar among oral and biologic
DMARDs. However, several studies suggest that
severe side effects are more common with biologic
DMARDs when compared with oral DMARDs. More
evidence is needed on drug combination therapies to
compare the value of different combination strategies
and different biologic DMARDs, timing and initiation
of therapies, and applicability of therapies in clinical
settings.
RA, which affects 1.3 million Americans, is an
autoimmune disease that involves inflammation of the
synovium (a thin layer of tissue lining a joint space)
with progressive erosion of bone leading in most cases
to misalignment of the joint, loss of function, and
disability. Treatment of patients with RA aims to
control pain and inflammation. The mean total annual
direct cost to patients with RA is estimated to be
$9,519 per person, with estimated indirect costs to be
roughly twice as much. Patients with arthritis
experience decreased quality of life, lower employment
rates, and greater direct and indirect costs.
These findings can be found in the review, Drug
Therapy for Rheumatoid Arthritis in Adults: An
Update. This research review adds to AHRQ's growing
library of resources for arthritis, one of AHRQ's
priority topics.
To access this review and other
materials that explore the effectiveness and risks of
treatment options for various conditions, visit the
Effective Health Care Program Web site at
http://www.effectivehealthcare.ahrq.gov.
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