Comparative effectiveness of rheumatoid arthritis therapies

被引:3
作者
Finckh A. [1 ]
机构
[1] Division of Rheumatology, Department of Internal Medicine, University Hospital of Geneva, 26 Avenue Beau-Sejour, Geneva
关键词
Antirheumatic therapy; Comparative effectiveness; DMARDs; Rheumatoid arthritis;
D O I
10.1007/s11926-010-0123-0
中图分类号
学科分类号
摘要
Physicians and patients must choose between several therapeutic interventions for rheumatoid arthritis and need to compare the available therapeutic options. Although randomized, placebo-controlled trials are essential to establish the efficacy of a new treatment, they are not much help when it comes to selecting the best therapy for an individual patient. Comparative effectiveness research (CER) is set to provide direct comparisons between therapeutic strategies. CER attempts to weigh the benefits against the potential harms of a particular intervention. Furthermore, CER may help identify specific patient subgroups that are more likely to benefit from a particular therapy or at increased risk of adverse events. Several study designs are available for CER, including pragmatic trials, indirect comparisons using meta-analysis, and observational studies. Understanding the strengths and weaknesses of each design improves the interpretation of the results. In this article, I illustrate CER principles using examples from the literature on biologic antirheumatic agents. © Springer Science+Business Media, LLC 2010.
引用
收藏
页码:348 / 354
页数:6
相关论文
共 52 条
[1]  
Orszag P.R., Ellis P., Addressing rising health care costs-A view from the Congressional Budget Office, N Engl J Med, 357, pp. 1885-1887, (2007)
[2]  
Vanlare J.M., Conway P.H., Sox H.C., Five next steps for a new national program for comparative-effectiveness research, N Engl J Med, 362, pp. 970-973, (2010)
[3]  
Schiff M.K., Keiserman M., Codding C., Et al., Efficacy and safety of abatacept or infliximab vs placebo in ATTEST: A phase III, multicentre, randomised, double-blind, placebo-controlled study in patients with rheumatoid arthritis and an inadequate response to methotrexate, Ann Rheum Dis, 67, pp. 1096-1103, (2008)
[4]  
O'dell J.R., It is the best of times
[5]  
It is the worst of times: Is there a way forward? A plethora of treatment options for rheumatoid arthritis, but critical trial design issues, Arthritis Rheum, 56, pp. 3884-3886, (2007)
[6]  
Donahue K.E., Gartlehner G., Jonas D.E., Et al., Systematic review: Comparative effectiveness and harms of disease-modifying medications for rheumatoid arthritis, Ann Intern Med, 148, pp. 124-134, (2008)
[7]  
Boers M., A call for pragmatic treatment trials in rheumatoid arthritis, Nat Clin Pract Rheumatol, 4, pp. 292-293, (2008)
[8]  
Schwartz D., Lellouch J., Explanatory and pragmatic attitudes in therapeutical trials, J Chronic Dis, 20, pp. 637-648, (1967)
[9]  
Zwarenstein M., Treweek S., Gagnier J.J., Et al., Improving the reporting of pragmatic trials: An extension of the CONSORT statement, BMJ, 337, (2008)
[10]  
Tunis S.R., Stryer D.B., Clancy C.M., Practical clinical trials: Increasing the value of clinical research for decision making in clinical and health policy, JAMA, 290, pp. 1624-1632, (2003)