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Treatment impact on estimated medical expenditure and job loss likelihood in rheumatoid arthritis: re-examining quality of life outcomes from a randomized placebo-controlled clinical trial with abatacept.

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اقرأ أكثر حفظ في قائمتي
  • المؤلفون: Cole JC;Cole JC; Li T; Lin P; MacLean R; Wallenstein GV
  • المصدر:
    Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2008 Jul; Vol. 47 (7), pp. 1044-50. Date of Electronic Publication: 2008 May 17.
  • نوع النشر :
    Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • اللغة:
    English
  • معلومة اضافية
    • المصدر:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 100883501 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1462-0332 (Electronic) Linking ISSN: 14620324 NLM ISO Abbreviation: Rheumatology (Oxford) Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999-
    • الموضوع:
      Quality of Life*; Antirheumatic Agents/*therapeutic use ; Arthritis, Rheumatoid/*rehabilitation ; Health Care Costs/*statistics & numerical data ; Immunoconjugates/*therapeutic use; Abatacept ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/economics ; Double-Blind Method ; Female ; Health Status Indicators ; Humans ; Male ; Methotrexate/therapeutic use ; Middle Aged ; Psychometrics ; Treatment Failure ; Tumor Necrosis Factor-alpha/antagonists & inhibitors ; Unemployment ; United States
    • نبذة مختصرة :
      Objectives: Quality of life (QoL) improvement is important to demonstrate in RA clinical trials, but can be abstract. More meaningful measures of QoL include medical expenditure and job loss, aspects that have marked importance for RA patients, physicians and society. We re-examined previous positive QoL findings for abatacept over placebo by converting existing QoL measures into estimated medical expenditure and estimated likelihood of job loss.
      Methods: Two double-blind, placebo-controlled, multicentre randomized clinical trials were undertaken: one for MTX failure (n = 652) and one for more severe anti-TNF failure patients (n = 391). Based on derived scores using previously published formulae, measures of monthly medical expenditure, current inability to work and job loss at 6 months, 1 yr and 2 yrs were analysed.
      Results: Abatacept led to greater reduction in medical expenditure over time in MTX failure ($152 lower) and anti-TNF failure patients ($122 lower) compared with placebo at end-point. Likewise, significantly more reduction in likelihood for current and future job loss was achieved with abatacept compared with placebo, which has 25-64% greater likelihood.
      Conclusions: QoL changes provided greater reduction in medical expenditure and likelihood of an inability to work. The strong effect sizes obtained for all significant analyses suggest that the results are clinically meaningful. Moreover, given the nature of the variables, results should also be meaningful for patients, physicians, employers and health care insurance entities. Limitations are discussed regarding using estimated outcomes rather than analysis of actual outcomes.
    • الرقم المعرف:
      0 (Antirheumatic Agents)
      0 (Immunoconjugates)
      0 (Tumor Necrosis Factor-alpha)
      7D0YB67S97 (Abatacept)
      YL5FZ2Y5U1 (Methotrexate)
    • الموضوع:
      Date Created: 20080520 Date Completed: 20080724 Latest Revision: 20151119
    • الموضوع:
      20231215
    • الرقم المعرف:
      10.1093/rheumatology/ken141
    • الرقم المعرف:
      18487628