title: Assessing the value of rheumatoid arthritis treatment alternatives: the potential effect of tumor necrosis factor inhibitors.
abstract: Early intervention with drugs that delay structural damage from rheumatoid arthritis may limit disability and reduce the high costs associated with advancing disease. However, conventional agents have a potential for significant toxicities, which require monitoring that confers additional treatment costs. A new class of drugs has been developed: biologic response modifiers, two of which--etanercept and infliximab--inhibit tumor necrosis factor, a pivotal regulator of inflammation, and delay arthritic progression. Managed care organizations should encourage early diagnosis of rheumatoid arthritis, referral to a rheumatologist, and treatment with agents that reduce the overall costs of this debilitating disease.
authors.affiliation: Talbert Medical Group, Fountain Valley, California, USA. mizutaniw@prodigy.net
authors.forename: Wesley
authors.initials: W
authors.lastname: Mizutani
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics* / Q000503:physiopathology; D017281:Cost of Illness; D016527:Drug Costs; D000068800:Etanercept; D017048:Health Care Costs; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D000069285:Infliximab; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014481:United States
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D007155:Immunologic Factors; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept