title: Persistence and dose escalation of tumor necrosis factor inhibitors in US veterans with rheumatoid arthritis.
abstract: OBJECTIVE
  Limited evidence exists comparing the persistence, effectiveness, and costs of biologic therapies for rheumatoid arthritis in clinical practice. Comparative effectiveness studies are needed to understand real-world experience with these agents. We evaluated treatment patterns, costs, and effectiveness of tumor necrosis factor inhibitor (TNFi) agents in patients enrolled in the Veterans Affairs Rheumatoid Arthritis (VARA) registry.
  
  
  METHODS
  Observational data from the VARA registry and linked administrative databases were analyzed. Longitudinal data from VARA patients initiating adalimumab (ADA), etanercept (ETN), or infliximab (IFX) from 2003 (the date all agents were available within the Veteran Affairs) to 2010 were analyzed. Outcomes included Disease Activity Score using 28 joints (DAS28), treatment persistence, dose escalation, and direct costs of drugs and drug administration.
  
  
  RESULTS
  For 563 eligible patients, baseline DAS28, DAS28 improvements, and persistence on initial treatment were similar across agents. Fewer patients receiving ETN (n = 5/290; 2%) underwent dose escalation than did patients taking ADA (n = 32/204; 16%) or IFX (n = 44/69; 64%). Annual costs for first course of TNFi therapy were lower for injectable ADA ($13,100 US) and ETN ($13,500 US) than for intravenously administered IFX ($16,900 US).
  
  
  CONCLUSIONS
  Despite similar persistence and clinical disease activity for these TNFi agents, rates of dose escalation were highest with ADA and IFX. Higher overall costs were noted for IFX without increases in effectiveness.
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc. Grant.Cannon@va.gov.
authors.forename: Grant W
authors.initials: GW
authors.lastname: Cannon
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: Scott L
authors.initials: SL
authors.lastname: DuVall
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: Candace L
authors.initials: CL
authors.lastname: Haroldsen
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: Liron
authors.initials: L
authors.lastname: Caplan
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Curtis
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: Kaleb
authors.initials: K
authors.lastname: Michaud
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: Ted R
authors.initials: TR
authors.lastname: Mikuls
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: Andreas
authors.initials: A
authors.lastname: Reimold
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: David H
authors.initials: DH
authors.lastname: Collier
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: David J
authors.initials: DJ
authors.lastname: Harrison
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: George J
authors.initials: GJ
authors.lastname: Joseph
authors.affiliation: From the Veterans Affairs Salt Lake City Health Care System; University of Utah School of Medicine, Salt Lake City, Utah; Denver Veterans Affairs (VA); University of Colorado, Denver, Colorado; University of Alabama at Birmingham, Birmingham, Alabama; the University of Nebraska Medical Center; Omaha VA, Omaha, Nebraska; the National Data Bank for Rheumatic Diseases, Wichita, Kansas; Dallas VA; University of Texas Southwestern, Dallas, Texas; Amgen Inc., Thousand Oaks, California, USA.G.W. Cannon, MD, Associate Chief of Staff of Academic Affiliations; S.L. DuVall, PhD, Associate Director, VA Informatics and Computing Infrastructure and Research Assistant Professor; C.L. Haroldsen, MSPH, Senior Programmer/Analyst; B.C. Sauer, PhD, MS, Associate Professor, Veterans Affairs Salt Lake City Health Care System, University of Utah School of Medicine; L. Caplan, MD, PhD, Associate Professor of Medicine/Rheumatology, Denver VA, University of Colorado; J.R. Curtis, MD, MS, MPH, William J. Koopman Endowed Professor in Rheumatology and Immunology, Director, University of Alabama Birmingham (UAB) Arthritis Clinical Intervention Program, Co-director, UAB Center for Education and Research on Therapeutics, Co-director, UAB PharmacoEpidemiology and Economic Research Group, University of Alabama at Birmingham; K. Michaud, PhD, Assistant Professor of Medicine, Co-director, University of Nebraska Medical Center, National Data Bank for Rheumatic Diseases; T.R. Mikuls, MD, Staff Physician and Researcher, Professor of Internal Medicine and Rheumatology, Omaha VA, University of Nebraska Medical Center; A. Reimold, MD, Chief, Rheumatology Section, Associate Professor of Medicine, Dallas VA, University of Texas Southwestern; D.H. Collier, MD, Clinical Research Medical Director; D.J. Harrison, PhD, Health Economics Director, Amgen Inc.; G.J. Joseph, PhD, Health Economics Senior Manager, former employee of Amgen Inc.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Sauer
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D000068800:Etanercept / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012042:Registries; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014728:Veterans
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
keywords: ADALIMUMAB; ETANERCEPT; INFLIXIMAB; RHEUMATOID ARTHRITIS