Cost-effectiveness of Different Intra-articular Drug Injections on Wrist and/or Elbow Compromise in Patients With Established Rheumatoid Arthritis: Short-term Results of an Open Observational Evaluation
| Autor: | Wang Lei Du, Zhi Qin Li, Jin Ding, Zhen Biao Wu, Nan Leng, Zhaohui Zheng, Peng Zhao, Ping Zhu, Lin Xuan Pang, Xue Yi Li |
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| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
030203 arthritis & rheumatology Oligoarthritis medicine.diagnostic_test Visual analogue scale business.industry Cost effectiveness medicine.disease Etanercept 03 medical and health sciences 0302 clinical medicine Rheumatology Rheumatoid arthritis Erythrocyte sedimentation rate Synovitis Anesthesia medicine Betamethasone 030212 general & internal medicine business medicine.drug |
| Zdroj: | Journal of clinical rheumatology : practical reports on rheumaticmusculoskeletal diseases. |
| ISSN: | 1536-7355 |
| Popis: | BACKGROUND Intra-articular (IA) injections are an integral part of the management of rheumatoid arthritis (RA). However, there are few reports regarding the association between drug effectiveness and cost. OBJECTIVES The aim of this study was to assess the cost-effectiveness of various combinations of IA injections of betamethasone, hyaluronic acid (HA) or etanercept for oligoarthritis in RA. METHODS Seventy RA patients were assigned to 4 groups according to the IA injection drug(s): betamethasone alone, betamethasone + etanercept, betamethasone + HA, or etanercept alone. Data for the following were collected before and after IA injection: erythrocyte sedimentation rate, C-reactive protein (CRP), disease activity score in 28 joints calculated with CRP, and patient global visual analog scale. In addition, power Doppler ultrasonography and gray-scale ultrasonography scores were obtained for synovitis, and passive range of motion of joints was measured. RESULTS Sixty-eight RA patients completed the trial. Compared with patients given etanercept alone, the visual analog scale, power Doppler ultrasonography, and gray-scale ultrasonography scores of each of the other groups were significantly better at each time point. At 1 month, the passive range of motion of joints in patients given betamethasone + HA was significantly better than that of each of the other groups. Synovial hyperplasia improved significantly in all groups, but less so in those given etanercept alone. All other clinical parameters of the 4 groups were similar. The costs per joint for the betamethasone-alone, betamethasone + etanercept, betamethasone + HA, and etanercept-alone groups were, respectively, $7.55, $181.77, $42.68, and $174.22. CONCLUSIONS Intra-articular injection of betamethasone alone was the most cost-effective treatment for oligoarthritis of RA. Betamethasone combined with HA injection resulted in the best improvement in joint function. |
| Databáze: | OpenAIRE |
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