Evidence map›Paper›PMID 29296125›Full record

ArticleThe open rheumatology journal2017

Dose Escalation and Co-therapy Intensification Between Etanercept, Adalimumab, and Infliximab: The CADURA Study.

Carter Thorne, Gilles Boire, Andrew Chow, Kirsten Garces, Fang Liu, Melanie Poulin-Costello, Valery Walker, Boulos Haraoui

Open access · diamondAbstract read
In one paragraph

Article in The open rheumatology journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Carter ThorneThe Arthritis Program Research Group, Southlake Regional Health Centre, c/o 43 Lundy's Lane, Newmarket, ON, L3Y 3R7, Canada.
Gilles BoireCentre Hospitalier Universitaire de Sherbrooke (CIUSSS de l'Estrie-CHUS), Université de Sherbrooke, Sherbrooke, QC, Canada.
Andrew ChowCredit Valley Rheumatology, Mississauga, ON, Canada.
Kirsten GarcesAmgen Canada Inc., Mississauga, ON, Canada.
Fang LiuOptum, 5500 North Service Road, Suite 501, Burlington, ON, L7L 6W6, Canada.
Melanie Poulin-CostelloAmgen Canada Inc., Mississauga, ON, Canada.
Valery WalkerOptum, 5500 North Service Road, Suite 501, Burlington, ON, L7L 6W6, Canada.
Boulos HaraouiInstitut de Rhumatologie de Montreal, Montreal, QC, Canada.
Amgen (Canada) · CASouthlake Regional Health Center · CACentre Hospitalier Universitaire de Sherbrooke · CACredit Valley Hospital · CAMontreal Clinical Research Institute · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare anti-TNF dose escalation, DMARD and/or glucocorticoid intensification, switches to another biologic, and drug and drug-related costs over 12 and 18 months for rheumatoid arthritis (RA) patients initiating etanercept (ETN), adalimumab (ADA), or infliximab (IFX) in routine clinical practice across Canada.

methodsA retrospective chart review of biologic-naïve adult RA patients newly initiating ADA, ETN, or IFX between January 01, 2006 and December 31, 2012 from 11 practices across Canada.

resultsThere were 314 patients in the 12-month analysis and 217 in the 18-month analysis. No dose escalation occurred with ETN over 12 and 18 months versus 38% and 32% for IFX (p<0.001) and 2% and 2% for ADA (p=0.199, p=0.218). Over 18 months, dose escalation and/or DMARD and/or glucocorticoid intensification was less frequent among ETN (16%) versus IFX (44%, p=0.005) and ADA (34%, p=0.004). By 18 months, 22% of patients initiating ADA had switched to another biologic compared with 6% of ETN patients (p=0.001).Patients initiating ETN had lower total (drug and drug-related) costs over 12 and 18 months compared to IFX, and no difference compared to ADA when adjusted for potential confounders. Patients with dose escalation had higher costs compared to those with no dose escalation.

conclusionPhysicians were more likely to escalate the dose of IFX, but optimize co-therapy with ADA and ETN. ETN patients had no dose escalation and were less likely to have DMARD and/or glucocorticoid intensification than ADA patients. ETN-treated patients had lower costs compared to IFX patients.

Indexed as

AdalimumabDose escalationEtanerceptInfliximabIntensificationRheumatoid arthritis

Identifiers

PMID29296125
PMCPMC5744265
OpenAlexW2765735024

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.