Assessing the value of rheumatoid arthritis treatment alternatives: the potential effect of tumor necrosis factor inhibitors.
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.
Mizutani
Wesley
W
Talbert Medical Group, Fountain Valley, California, USA. mizutaniw@prodigy.net
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
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