Agency News and Notes

Limited evidence prevents firm conclusions on rheumatoid arthritis drug therapies

A newly updated research review from the Effective Health Care Program of the Agency for Healthcare Research and Quality (AHRQ) reinforces the current standards of care for drug therapies used to treat rheumatoid arthritis (RA). The review concluded that there is not enough evidence to determine which individual oral disease-modifying antirheumatic drug (DMARD) or combination therapy is best. Overall tolerability is similar among oral and biologic DMARDs. However, several studies suggest that severe side effects are more common with biologic DMARDs when compared with oral DMARDs. More evidence is needed on drug combination therapies to compare the value of different combination strategies and different biologic DMARDs, timing and initiation of therapies, and applicability of therapies in clinical settings.
RA, which affects 1.3 million Americans, is an autoimmune disease that involves inflammation of the synovium (a thin layer of tissue lining a joint space) with progressive erosion of bone leading in most cases to misalignment of the joint, loss of function, and disability. Treatment of patients with RA aims to control pain and inflammation. The mean total annual direct cost to patients with RA is estimated to be $9,519 per person, with estimated indirect costs to be roughly twice as much. Patients with arthritis experience decreased quality of life, lower employment rates, and greater direct and indirect costs.
These findings can be found in the review, Drug Therapy for Rheumatoid Arthritis in Adults: An Update. This research review adds to AHRQ's growing library of resources for arthritis, one of AHRQ's priority topics.

To access this review and other materials that explore the effectiveness and risks of treatment options for various conditions, visit the Effective Health Care Program Web site at http://www.effectivehealthcare.ahrq.gov.