Abstract
Tumor necrosis factor (TNF) antagonists provide a clinically and economically efficient treatment option for psoriatic arthritis (PsA). PsA is a chronic inflammatory disease affecting the musculoskeletal system that, if untreated, can be disabling due to the progressive joint damage and the considerable impact on functional status and health-related quality of life. Therapies for PsA have been disappointing until recently. Traditional disease-modifying drugs are used to control symptoms, but there is no evidence that they slow the progression of the damage in peripheral joints. The introduction of the TNF-α-blocking agents has revolutionized the therapeutic management of PsA. These drugs lessen symptoms and signs of inflammation, enhance quality of life and functional capacity, and hinder the evolution of structural joint damage. TNF-α blockers are very expensive and not easily available to all patients, either depending on a national system or private insurance. Nevertheless, recent pharmacoeconomic studies have demonstrated that TNF-α blockers are cost-effective treatment options for the musculoskeletal and cutaneous manifestations of psoriatic disease.
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References and Recommended Reading
Mooney GH, Drummond MF: Essentials of health economics: Part I. What is economics. Br Med J (Clin Res Ed) 1982, 285:949–950.
Drummond MF, Sculpher MJ, Torrance GW, et al.: Methods for the Economic Evaluation of Health Care Programmes, edn 3. Oxford, United Kingdom: Oxford University Press; 2005.
National Center of Health Statistics: 1996. Healthy people review. Hyattsville, MD: Public Health Service; 1995–1996.
Murray CJ, Lopez AD: Global mortality, disability, and contribution of risk factors: Global Burden of Disease Study. Lancet 1997, 349:1436–1442.
McHugh NJ, Balachrishnan C, Jones SM: Progression of peripheral joint disease in psoriatic arthritis: a 5-yr prospective study. Rheumatology (Oxford) 2003, 42:778–783.
Gladman DD, Stafford-Brady F, Chang CH, et al.: Longitudinal study of clinical and radiological progression in psoriatic arthritis. J Rheumatol 1990, 17:809–812.
Torre-Alonso JC, Rodriguez-Perez A, Arribas Castrillo JM, et al.: Psoriatic arthritis (PA): a clinical, immunological and radiological study of 180 patients. Br J Rheumatol 1991, 30:245–250.
Kane D, Stafford L, Bresnihan B, FitzGerald O: A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience. Rheumatology (Oxford) 2003, 42:1460–1468.
Palazzi C, D’Agostino L, D’Amico E, et al.: Asymptomatic erosive peripheral psoriatic arthritis: a frequent finding in Italian patients. Rheumatology (Oxford) 2003, 42:909–911.
Scarpa R, Cuocolo A, Peluso R, et al.: Early psoriatic arthritis: the clinical spectrum. J Rheumatol 2008, 35:137–141.
Lindqvist UR, Alenius GM, Husmark T, et al.: The Swedish early psoriatic arthritis register—2-year follow-up: a comparison with early rheumatoid arthritis. J Rheumatol 2008, 35:668–673.
Husted JA, Gladman DD, Farewell VT, et al.: Validating the SF-36 health survey questionnaire in patients with psoriatic arthritis. J Rheumatol 1997, 24:511–517.
Gladman DD: Disability and quality of life considerations. Psoriatic arthritis. In Psoriatic and Psoriatic Arthritis: An Integral Approach. Edited by Gordon GB, Ruderman E. Heidelberg, Germany: Springer-Verlag; 2005:118–123.
Drummond MF, O’Brien B, Stoddard GL, Torrance GW: Method for the Economic Evaluation in Health Care Programmes, edn 2. Oxford, United Kingdom: Oxford University Press; 1997.
Bansback NJ, Ara R, Barkham N, et al.: Estimating the cost and health status consequences of treatment with TNF antagonists in patients with psoriatic arthritis. Rheumatology (Oxford) 2006, 45:1029–1038.
Eandi M, Salvarani C: Pharmacoeconomic analysis of biological drugs for the treatment of psoriatic arthritis [in Italian]. Farmacoeconomia e Percorsi Terapeutici 2006, 7:171–186.
Woolacott N, Bravo Vergel Y, Hawkins N, et al.: Etanercept and infliximab for the treatment of psoriatic arthritis: a systematic review and economic evaluation. Health Technol Assess 2006, 10:1–239.
Kavanaugh A, Antoni C, Mease P, et al.: Effect of infliximab therapy on employment, time lost from work, and productivity in patients with psoriatic arthritis. J Rheumatol 2006, 33:2254–2259.
Bravo Vergel Y, Hawkins NS, Claxton K, et al.: The cost-effectiveness of etanercept and infliximab for the treatment of patients with psoriatic arthritis. Rheumatology 2007, 46:1729–1735.
Olivieri I, de Portu S, Salvarani C, et al.: The psoriatic arthritis cost evaluation study: a cost-of-illness study on tumour necrosis factor inhibitors in psoriatic arthritis patients with inadequate response to conventional therapy. Rheumatology 2008, 47:1664–1670.
Sizto S, Bansback N, Feldman SR, et al.: Economic evaluation of systemic therapies for moderate to severe psoriasis. Br J Dermatol 2009, 160:1264–1272.
Sokoll KB, Helliwell PS: Comparison of disability and quality of life in rheumatoid and psoriatic arthritis. J Rheumatol 2001, 28:1842–1846.
Gladman DD: Psoriatic arthritis. In Kelley’s Textbook of Rheumatology, edn 7. Edited by Harris ED Jr, Budd RC, Firestein GS, et al.: Philadelphia: Elsevier Saunders; 2005:1155–1164.
Queiro R, Torre JC, Belzunegui J, et al.: Clinical features and predictive factors in psoriatic arthritis-related uveitis. Semin Arthritis Rheum 2002, 31:264–270.
Scarpa R, Manguso F, D’Arienzo A, et al.: Microscopic inflammatory changes in colon of patients with both active psoriasis and psoriatic arthritis without bowel symptoms. J Rheumatol 2000, 27:1241–1246.
Mallbris L, Ritchlin CT, Ståle M: Metabolic disorders in patients with psoriasis and psoriatic arthritis. Curr Rheumatol Rep 2006, 8:355–363.
Neimann AL, Shin DB, Wang X, et al.: Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol 2006, 55:829–835.
Tam LS, Tomlinson B, Chu TT, et al.: Cardiovascular risk profile of patients with psoriatic arthritis compared to controls—the role of inflammation. Rheumatology (Oxford) 2008, 47:718–723.
Scarpa R, Ayala F, Caporaso N, Olivieri I: Psoriasis, psoriatic arthritis, or psoriatic disease? J Rheumatol 2006, 33:210–212.
Ritchlin C: Psoriatic disease—from skin to bone. Nat Clin Pract Rheumatol 2007, 3:698–706.
Ritchlin C: From skin to bone: translational perspectives on psoriatic disease. J Rheumatol 2008, 35:1434–1437.
Dougados M, van der Linden S, Juhlin R, et al.: The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 1991, 34:1218–1227.
Olivieri I, van Tubergen A, Salvarani C, van der Linden S: Seronegative spondyloarthritides. Best Pract Res Clin Rheumatol 2002, 16:723–739.
Wong K, Gladman DD, Husted J, et al.: Mortality studies in psoriatic arthritis: results from a single outpatient clinic. I. Causes and risk of death. Arthritis Rheum 1997, 40:1868–1872.
Gladman DD, Farewell VT, Wong K, Husted J: Mortality studies in psoriatic arthritis: results from a single outpatient center. II. Prognostic indicators for death. Arthritis Rheum 1998, 41:1103–1110.
Mease PJ, Kivitz AJ, Burch FX, et al.: Etanercept treatment of psoriatic arthritis. Safety, efficacy, and effect on disease progression. Arthritis Rheum 2004, 50:2264–2272.
Kavanaugh A, Antoni C, Gladman DD, et al.: The Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT): results of radiographic analyses after 1 year. Ann Rheum Dis 2006, 65:1038–1043.
Mease P, Gladman DD, Ritchlin CT, et al.: Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis Rheum 2005, 52:3279–3289.
Zochling J, van der Heijde D, Dougados M, Braun J: Current evidence for the management of ankylosing spondylitis: a systematic literature review for the ASAS/EULAR management recommendations in ankylosing spondylitis. Ann Rheum Dis 2006, 65:423–432.
Ritchlin CT, Kavanaugh A, Gladman DD, et al.: Treatment recommendations for psoriatic arthritis. Ann Rheum Dis 2008 Oct 24 (Epub ahead of print).
Olivieri I, D’Angelo S, Palazzi C, Padula A: Treatment strategies for early psoriatic arthritis. Expert Opin Pharmacother 2009, 10:271–282.
Javitz HS, Ward MM, Farber E, et al.: The direct cost of care for psoriasis and psoriatic arthritis in the United States. J Am Acad Dermatol 2002, 46:850–860.
Huscher D, Merkesdal S, Thiele K, et al.: Cost of illness in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus in Germany. Ann Rheum Dis 2006, 65:1175–1183.
Kraning KK, Odland GF: Psoriasis. J Invest Dermatol 1979, 73:402–413.
Krueger GG, Bergstresser PR, Lowe NJ, et al.: Psoriasis. J Am Acad Dermatol 1984, 11:937–947.
Ackermann C, Kavanaugh A: Economic burden of psoriatic arthritis. Pharmacoeconomics 2008, 26:121–129.
Kavanaugh A: Health economics: implications for novel antirheumatic therapies. Ann Rheum Dis 2005, 64:iv65–69.
Kavanaugh A: Pharmacoeconomic considerations in the treatment of psoriatic arthritis. Rheumatology (Oxford) 2006, 45:790–791.
Messori A, Santarlasci B, Trippoli S, Vaiani M: Drug economic equivalent and clinical benefit: state of the art on methodology and application of a pharmacoeconomic algorithm. Pharmacoeconomics—Italian Research Articles 2003, 5:53–67.
Kimball AB, Jackson JM, Sobell JM, et al.: Reductions in healthcare resource utilization in psoriatic arthritis patients receiving etanercept therapy: results from the educate trial. J Drugs Dermatol 2007, 6:299–306.
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Olivieri, I., Mantovani, L.G., D’Angelo, S. et al. Psoriatic arthritis: Pharmacoeconomic considerations. Curr Rheumatol Rep 11, 263–269 (2009). https://doi.org/10.1007/s11926-009-0037-x
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DOI: https://doi.org/10.1007/s11926-009-0037-x