Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Clinical effectiveness of biologics in clinical practice. | Scott and Kingsley Arthritis Research Therapy 2010 12 115 http content 12 2 115 EDITORIAL L_ Clinical effectiveness of biologies in clinical practice David L Scott and Gabrielle Kingsley See related research by Wolfe and Michaud http content 12 2 R35 Abstract TNF inhibitors are currently considered both effective and cost-effective in patients with active rheumatoid arthritis RA particularly in patients who have not responded fully to methotrexate. There is substantial doubt about the cost-effectiveness of TNF inhibitors as initial treatment for active RA. New data from the National Data Bank for Rheumatic Diseases now question the current consensus in methotrexate failures. The data suggest that in routine clinical practice TNF inhibitors provide only modest incremental benefits over best conventional therapy. If confirmed these observational studies suggest that the economic argument underpinning the widespread use of TNF inhibitors in established RA is unsustainable. The prevailing clinical consensus is that TNF inhibitors are both effective and cost-effective in patients with established active rheumatoid arthritis RA who have failed to respond to methotrexate. This consensus is challenged by new research from Wolfe and Michaud 1 . Their findings although important are controversial. We have placed these findings into context by outlining the cases for and against the current use of TNF inhibitors. Three strands of evidence support using TNF inhibitors. Firstly the inhibitors reduce joint inflammation. Secondly TNF inhibitors improve disability measured using the health assessment questionnaire HAQ . Thirdly HAQ scores do not increase in patients receiving TNF inhibitors but continue to increase in patients with active RA receiving disease-modifying anti-rheumatic drugs DMARDs . Economic modelling suggests TNF inhibitors are cost-effective and regulators like the National Institute for Health and Clinical .
