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Highly Accessed Editorial

Clinical effectiveness of biologics in clinical practice

David L Scott* and Gabrielle Kingsley

Author Affiliations

Department of Rheumatology, Weston Education Centre, King's College London, Cutcombe Road, London SE5 9RJ, UK

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Arthritis Research & Therapy 2010, 12:115  doi:10.1186/ar2970


See related research by Wolfe and Michaud, http://arthritis-research.com/content/12/2/R35

Published: 28 April 2010

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.