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Extended report
Rapid and sustained health utility gain in anti-tumour necrosis factor-treated inflammatory arthritis: observational data during 7 years in southern Sweden
  1. A Gülfe1,
  2. L E Kristensen1,
  3. T Saxne1,
  4. L T H Jacobsson2,
  5. I F Petersson3,
  6. P Geborek1
  1. 1
    Department of Rheumatology, Lund University Hospital, Lund, Sweden
  2. 2
    Department of Rheumatology, Malmö University Hospital, Malmö, Sweden
  3. 3
    South Sweden Musculoskeletal Research Centre, Department of Orthopedics, Lund University Hospital, Lund, Sweden
  1. Correspondence to Dr P Geborek, Department of Rheumatology, Lund University Hospital, SE-221 85 Lund, Sweden; Pierre.geborek{at}


Background: Rheumatoid arthritis (RA), psoriatic arthritis (PsA) and other spondylarthritides impose a great impact on the individual in addition to the costs on society, which may be reduced by effective pharmacological treatment. Industry-independent health economic studies should complement studies sponsored by industry.

Objective: To study secular trends in baseline health utilities in patients commencing tumour necrosis factor (TNF) blockade for arthritis in clinical practice over 7 years; to address utility changes during treatment; to investigate the influence of previous treatment courses; to study the feasibility of health utility measures and to compare them across diagnostic entities.

Methods: EuroQoL 5 dimensions (EQ-5D) utility data were collected from a structured clinical follow-up programme of anti-TNF-treated patients with RA (N  =  2554), PsA (N  =  574) or spondylarthritides (N  =  586). Time trends were calculated. Completer analysis was used.

Results: There were weak or non-significant secular trends for increasing baseline utilities over time for RA, PsA and spondylarthritides. The maximum gain in utilities had already occurred after 2 weeks for all diagnoses and remained stable for patients remaining on therapy. The first and second anti-TNF courses performed similarly.

Conclusions: Utilities at inclusion remained largely unchanged for RA, PsA and spondylarthritides over 7 years. Improvement occurred early during treatment and not beyond 6 weeks at the group level. Improvement during the first course was not consistently greater than the second. There were no major differences between RA, PsA and spondylarthritides. EQ-5D proved feasible and applicable across these diagnoses. These “real world” data may be useful for health economic modelling.

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  • ▸ Additional supplemental table 1 is published online only at

  • Funding This study was supported by grants from Österlund and Kock Foundations, King Gustav V 80 year fund, Lund University Hospital, Region Skåne, Faculty of Medicine, Lund University and Reumatikerförbundet.

  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.