Cost‐Effectiveness Analysis of Two Rituximab Retreatment Regimens for Longstanding Rheumatoid Arthritis. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Quartuccio, Luca; di Bidino, Rossella; Ruggeri, Matteo; Schiavon, Franco; Biasi, Domenico; Adami, Silvano; Punzi, Leonardo; Cicchetti, Americo; de Vita, Salvatore
• Is Part Of: Arthritis care & research. Volume 67:Issue 7(2015:Jul.)
• Page Start: 947
• Page End: 955
• Publication Date: 2015-07
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.22534
• Languages: English
• ISSNs: 2151-464X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="acr22534-sec-0001" sec-type="section"> <title>Objective</title> <p>Rituximab (RTX) is licensed for second‐line treatment of rheumatoid arthritis (RA) after first tumor necrosis factor (TNF) inhibitor failure. RTX is generally administered intravenously at 1 gm 2 weeks apart, and the retreatment is scheduled at the time of clinical relapse (regimen 1). A more intensive regimen is proposed with a fixed full cycle after 6 months (regimen 2) if remission is not reached. A cost‐effectiveness analysis (CEA) compared these 2 regimens of RTX administration in patients with longstanding RA based on data provided by an observational study.</p> </sec> <sec id="acr22534-sec-0002" sec-type="section"> <title>Methods</title> <p>An observational retrospective study was conducted on 102 patients, enrolled in 3 hospitals and followed for ≥12 months. Forty‐seven patients followed regimen 1, while 55 patients followed regimen 2. A CEA based on a Markov model was conducted. A lifelong and social perspective was adopted. CEA was conducted for the entire cohort and for the 2 subgroups separately (patients with positive rheumatoid factor and/or anti–cyclic citrullinated peptide and failures to TNF inhibitors).</p> </sec> <sec id="acr22534-sec-0003" sec-type="section"> <title>Results</title> <p>Results for the overall sample show at 10, 20, and 30 years that regimen 1 is less costly and associated with a higher quality of life compared to regimen 2. Probabilistic sensitivity analysis at 10 years estimated a probability of 95.1% for regimen 1 to be cost effective given a willingness to pay of €35, 000/quality‐adjusted life year, while for seropositive patients and for TNF failures it was estimated to be 92% and 92.7%, respectively.</p> </sec> <sec id="acr22534-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In longstanding RA, cost effectiveness of RTX retreatment at clinical relapse was found to be at least equivalent to the more intensive regimen proposed.</p> </sec> </abstract>