Stopping expensive tumour necrosis factor inhibitors (TNFis) in patients with rheumatoid arthritis (RA) who are in remission, or who have low disease activity, can save considerable costs, but it results in a small loss of quality-adjusted life years (QALYs), according to new research.
For the study, researchers examined data from the Potential Optimalisation of Expediency and Effectiveness of TNFis (POET) trial which was carried out at 47 centres in the Netherlands. Patients were randomised to the stop group (n=531) or to the continue group (n=186). Patients were assessed at baseline and at least once every three months thereafter, for a period of one year. Restart of a TNFi was allowed when a flare occurred.
The authors found that compared to continuation, stopping TNFis in RA patients with stable low disease activity, on average, was associated with a cost saving of €7,133, a loss of 0.022 QALYs and an increase of 0.41 flares per patient per year.
Presenting their findings in Arthritis & Rheumatology, the authors said the findings, together with other recent study conclusions suggest a significant potential to "free up resources that could be reallocated to other more cost-effective interventions".