BMJ editorial: Treating rheumatoid arthritis.
The authors of this editorial discuss the use of anti-TNF agents in the treatment of rheumatoid arthritis (RA). They refer to recent trials in this area of practice, one which suggested that these agents may produce remission in patients if used early. Questioning whether patients with a poor prognosis should receive anti-TNF as first line treatment, the authors conclude: “If the cost of the drugs was minimal, the only relevant comparator would be combination regimens with corticosteroids and methotrexate as the anchoring drugs. Cost effectiveness analyses are under way and will influence how widespread such an approach is likely to be. The success of the treatment-to-target strategy supports its use in clinical practice whenever possible. The data also suggest that patients with rheumatoid arthritis can achieve remission, but for them to cease treatment and remain in remission they must be treated early on in the disease process. However, sufficient uncertainty exists to warrant further double blinded trials and analyses of their costs.”
BMJ 2007; 335: 56-7 (link to extract)