History of development of TNF inhibitors

Stevens, Seth R.; Chang, Teng-Wen

doi:10.1007/3-7643-7438-1_2

Cited by 6 publications

(4 citation statements)

References 64 publications

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“…TNF-α is considered a 'master-regulator' of inflammatory cytokine production because of its pivotal role in orchestrating the cytokine cascade in many chronic inflammatory conditions such as rheumatoid arthritis, psoriasis and IBD. Since the 1990s, the development and use of drugs which inhibit TNF-α action has revolutionised the management of these immunemediated diseases (57) . Infliximab, adalimumab, golimumab and certolizumab are TNF-α inhibitors used in the treatment of IBD.…”

Section: Biologic Agentsmentioning

confidence: 99%

Inflammatory bowel disease and the gut microbiota

Mah

Koentgen

et al. 2021

Proc. Nutr. Soc.

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Section: Biologic Agentsmentioning

confidence: 99%

Inflammatory bowel disease and the gut microbiota

Mah

Koentgen

et al. 2021

Proc. Nutr. Soc.

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“…The advent of biologic medications such as subcutaneous tumor necrosis factor-alpha inhibitors (SC-TNFis) has transformed the management of IMRDs 4. Despite the benefits of biologic treatment, a significant proportion of patients with IMRDs fail to respond, lose response, or experience adverse events with first-line biologic treatment and may therefore require treatment with other biologics 5…”

Section: Introductionmentioning

confidence: 99%

Persistence and costs with subcutaneous TNF-alpha inhibitors in immune-mediated rheumatic disease stratified by treatment line

Svedbom¹,

Dalén²,

Black³

et al. 2017

PPA

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ObjectivesThe objectives of this study were to 1) describe and compare treatment persistence with first- and second-line subcutaneous tumor necrosis factor-alpha inhibitors (SC-TNFis) in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA), or rheumatoid arthritis (RA) (collectively immune-mediated rheumatic disease) in Sweden and 2) estimate and contrast health care costs in the two groups.MethodsPatients who initiated their first or second SC-TNFi between May 6 2010 and December 12 2012 were identified from the Prescribed Drug Register. Persistence was estimated using survival analysis. Costs comprised specialized outpatient care, inpatient care, and medication. The persistence analysis was stratified by immune-mediated rheumatic disease diagnosis.ResultsA total of 4,903 patients treated with their first and 845 patients treated with their second SC-TNFi were identified. Baseline characteristics differed between the two groups. Therefore, propensity score matching analysis was implemented. Second-line patients were matched to first-line patients, and four cohort pairs (AS, PsA, RA, and all diagnoses combined) were generated. Patients treated with their first SC-TNFi had statistically significant higher persistence than patients treated with their second SC-TNFi in PsA (P=0.036), RA (P=0.048), and all diagnoses combined (P<0.001) but not in AS (P=0.741). Patients who were treated with their second SC-TNFi incurred higher costs than patients treated with their first SC-TNFi.ConclusionOverall, persistence to the first SC-TNFi was higher than persistence to the second SC-TNFi. Furthermore, the second SC-TNFi was associated with higher costs than the first SC-TNFi. Therefore, prescribing the SC-TNFi with the best long-term persistence first may be beneficial.

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“…Disease management in IA has transformed over the recent decades with the addition of biologic disease-modifying anti-rheumatic drugs (bDMARDs), including subcutaneous TNF-a inhibitors (SC-TNFi) [6]. Apart from being a surrogate marker for clinical effectiveness, safety and treatment satisfaction in IA [7][8][9], treatment persistence with SC-TNFis has also been associated with significant cost offsets in health-care resource utilization (HCRU) [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Health-Care and Societal Costs Associated with Non-Persistence with Subcutaneous TNF-α Inhibitors in the Treatment of Inflammatory Arthritis (IA): A Retrospective Observational Study

Dalén¹,

Chitkara

Svedbom³

et al. 2021

Adv Ther

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Objective A few studies have suggested that patients with inflammatory arthritis (IA) who remain persistent with subcutaneous TNF-α inhibitors (SC-TNFi) incur lower health care costs than patients who discontinue treatment, whereas data on the impact of non-persistence on indirect costs are largely lacking. Furthermore, existing estimates are based on fixed follow-ups, in relation to treatment initiation, and therefore do not measure costs in direct relation to treatment discontinuation. Therefore, by capturing costs in direct relation to treatment discontinuation, this study aimed to estimate direct and indirect costs associated with non-persistence with SC-TNFis in IA. Methods Adult Swedish biologic-naïve IA patients initiating biologic treatment with a SC-TNFi (adalimumab, etanercept, certolizumab or golimumab) between May 6, 2010, and December 31, 2017, were identified in population-based registers with almost complete coverage. IA was defined as a diagnosis of rheumatic arthritis, ankylosing spondylitis/unspecified spondyloarthritis or psoriatic arthritis. Non-persistent patients were matched on propensity score to patients persistent with treatment by at least an additional 12 months. This enabled comparisons of direct healthcare costs and indirect costs for sick leave and disability pension, respectively, 12 months before and 12 months after treatment discontinuation. Results A balanced cohort of 486 matched pairs was generated. The total direct and indirect costs were significantly higher among non-persistent patients already during the 12 months before index ($20,802 [18,335–23,429] vs. $16,600 [14,331–18,696]). However, while non-persistent patients increased their total direct and indirect costs, persistent patients significantly decreased the same, further widening the difference in costs during the 12-month period after index date ($22,161 [19,754–24,556] vs. $13,465 [11,415–15,729]). Conclusions Among biologic-naïve Swedish IA patients treated with SC-TNFis, persistent patients incurred about 40% lower aggregated direct and indirect costs compared to non-persistent patients the year following SC-TNFi discontinuation. This highlights the impact of treatment persistence from an economic viewpoint, adding further aspects to the clinical perspective. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01970-w.

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History of development of TNF inhibitors

Cited by 6 publications

References 64 publications

Inflammatory bowel disease and the gut microbiota

Inflammatory bowel disease and the gut microbiota

Persistence and costs with subcutaneous TNF-alpha inhibitors in immune-mediated rheumatic disease stratified by treatment line

Health-Care and Societal Costs Associated with Non-Persistence with Subcutaneous TNF-α Inhibitors in the Treatment of Inflammatory Arthritis (IA): A Retrospective Observational Study

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