Effects of DMARD Tapering on Treatment Costs and Work Productivity in Rheumatoid Arthritis Patients- an Analysis from the Prospective Randomized Controlled Retro- Study

Melanie Hagen¹, Camille P Figueiredo², Jayme Fogagnolo Cobra³, Judith Haschka⁴, Michaela Reiser⁵, Matthias Englbrecht⁶, Axel J. Hueber⁷, Bernhard Manger⁶, Arnd Kleyer⁸, Stephanie Finzel⁹, Hans-Peter Tony¹⁰, Stefan Kleinert¹¹, Joerg Wendler¹², Florian Schuch¹², Monika Ronneberger¹², Martin Feuchtenberger¹³, Martin Fleck¹⁴, Karin Manger¹⁵, Wolfgang Ochs¹⁶, Matthias Schmitt-Haendle¹⁷, H.-M. Lorenz¹⁸, HG Nüßlein¹⁹, R Alten²⁰, Joerg C. Henes²¹, Klaus Krüger²², Georg Schett⁷ and Juergen Rech⁷, ¹Internal Medicine 3 – Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany, ²Rheumatology Division, Faculdade de Medicina da USP, São Paulo, Brazil, ³Instituto de Reumatologia de Sao Paolo, Sao Paolo, Brazil, ⁴Medical Department II, St. Vincent Hospital, the VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria, Vienna, Austria, ⁵Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany, ⁶Department of Internal Medicine 3, Rheumatology & Clinical Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany, ⁷Department of Internal Medicine 3 – Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany, ⁸Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany, ⁹Rheumatology and Clinical Immunology, University Medical Center Freiburg, Freiburg, Freiburg, Germany, ¹⁰Rheumatology/Immunology, Medical Clinic II, University Clinic Wuerzburg, Würzburg, Germany, ¹¹Rheumatologische Schwerpunktpraxis Erlangen, Erlangen, Germany, ¹²Schwerpunktpraxis Rheumatologie, Erlangen, Germany, ¹³Rheumatologie/Klinische Immunologie, Kreiskliniken Altötting-Burghausen, Burghausen, Germany, ¹⁴Department of Internal Medicine I, University of Regensburg, 93042 Regensburg, Germany, ¹⁵Rheumatology Practice Bamberg, Bamberg, Germany, ¹⁶Internistisch-rheumatologische Praxisgemeinschaft Bayreuth, Bayreuth, Germany, ¹⁷Rheumatology Practice, Bayreuth, Germany, Bayreuth, Germany, ¹⁸Im Neuenheimer Feld 41, UNI-Klinikum Heidelberg, Medizinische Klinik,, Heidelberg, Germany, ¹⁹University of Erlangen, Nürnberg, Germany, ²⁰Rheumazentrum Ruhrgebiet, Herne, Germany, ²¹Department of Internal Medicine II, Division of Rheumatology, University Hospital Tuebingen, Tuebingen, Germany, ²²Praxiszentrum St. Bonifatius, München, Germany

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Biologic drugs, DMARDs, remission, rheumatoid arthritis (RA) and treatment guidlelines

Session Information

Date: Sunday, November 13, 2016

Title: Health Services Research - Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Effects of DMARD Tapering on Treatment Costs and Work Productivity in Rheumatoid Arthritis Patients- an Analysis from the Prospective Randomized Controlled RETRO- Study

Background/Purpose:

Achieving remission is the most important treatment goal in patients with rheumatoid arthritis (RA). With the development and wider use of highly effective disease modifying anti-rheumatic drugs (DMARD) about half of RA patients reach a state of disease remission, raising the question about tapering or stopping anti-rheumatic treatment. The aim of this study was to assess the effect of a controlled DMARD tapering regimen on treatment costs and work productivity in RA patients in remission.

Methods:

101 RA patients in sustained remission (DAS28 <2.6 for more than 6 months), enrolled in the multicenter randomized controlled RETRO Study, were analyzed (1). Patients either continued DMARDs (arm1), tapered dose by 50% (arm 2) or entire stopped DMARDs after tapering (arm 3) for one year. Assessment of DMARD costs and work productivity was done every three months in all 101 patients including those remaining in remission and those relapsing a re-starting their original DMARD regimen.

Results:

RA patients treated with conventional DMARDs, baseline quarterly treatment costs of 154€ remained stable in arm 1 (156€), while decreasing to 81€ in arm 2 and 75€ in arm 3. In patients treated with biologic DMARDs quarterly treatment costs were 5,708€ at baseline. They remained stable in arm1 (5,533€) and decreased to 3,036€ in arm 2 and 2,668€ in arm 3. Overall DMARD costs were reduced by 327,292€ within one year, while outcome was very good with patients either remaining in remission or immediately regaining remission when exposed to original DMARD regimen after relapse.

Conclusion:

Controlled tapering of DMARD treatment leads to effective reduction of treatment costs in RA patients in sustained remission.

Disclosure: M. Hagen, None; C. P. Figueiredo, None; J. F. Cobra, None; J. Haschka, None; M. Reiser, None; M. Englbrecht, None; A. J. Hueber, None; B. Manger, None; A. Kleyer, None; S. Finzel, None; H. P. Tony, Abbvie, BMS, Chugai, Janssen, Lilly, MSD, Novartis, Roche, Takeda, UCB, 5,Abbvie, BMS, Chugai, Janssen, Lilly, MSD, Novartis, Roche, Takeda, UCB, 8; S. Kleinert, None; J. Wendler, None; F. Schuch, None; M. Ronneberger, None; M. Feuchtenberger, None; M. Fleck, None; K. Manger, None; W. Ochs, None; M. Schmitt-Haendle, None; H. M. Lorenz, None; H. Nüßlein, None; R. Alten, Bristol-Myers Squibb, 2,Bristol-Myers Squibb, 8; J. C. Henes, None; K. Krüger, Novartis Pharma AG, 5; G. Schett, None; J. Rech, None.

To cite this abstract in AMA style:

Hagen M, Figueiredo CP, Cobra JF, Haschka J, Reiser M, Englbrecht M, Hueber AJ, Manger B, Kleyer A, Finzel S, Tony HP, Kleinert S, Wendler J, Schuch F, Ronneberger M, Feuchtenberger M, Fleck M, Manger K, Ochs W, Schmitt-Haendle M, Lorenz HM, Nüßlein H, Alten R, Henes JC, Krüger K, Schett G, Rech J. Effects of DMARD Tapering on Treatment Costs and Work Productivity in Rheumatoid Arthritis Patients- an Analysis from the Prospective Randomized Controlled Retro- Study [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/effects-of-dmard-tapering-on-treatment-costs-and-work-productivity-in-rheumatoid-arthritis-patients-an-analysis-from-the-prospective-randomized-controlled-retro-study/. Accessed .

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