Evidence map›Paper›PMID 39351606›Full record

Trial reportScandinavian journal of rheumatology2025

Cost-utility analysis of longstanding exercise therapy versus usual care in people with rheumatoid arthritis and severe functional limitations.

Mmh Teuwen, Sfe van Weely, Chm van den Ende, Mat van Wissen, Tpm Vliet Vlieland, W F Peter, A A den Broeder, D van Schaardenburg, Mgj Gademan, W B van den Hout

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Scandinavian journal of rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Trial
  2. 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

10 authors.

Mmh TeuwenDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-3235-7800
Sfe van WeelyDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0001-8560-4687
Chm van den EndeDepartment of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-4352-2824
Mat van WissenDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-2998-4256
Tpm Vliet VlielandDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0001-6322-3859
W F PeterDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0003-1456-2429
A A den BroederDepartment of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.ORCID 0000-0002-9012-4079
D van SchaardenburgReade, Center for Rehabilitation and Rheumatology, Amsterdam, The Netherlands.ORCID 0000-0003-4006-3762
Mgj GademanDepartment of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-6106-3385
W B van den HoutDepartment of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-6425-0135

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the cost-effectiveness of longstanding personalized exercise therapy compared with usual care in people with rheumatoid arthritis (RA) and severe functional disability.

methodIn this cost-utility analysis of a randomized controlled trial (n = 215), with 1 year follow-up, the study population comprised individuals with RA and reported severe difficulties in performing basic daily activities. Assessments were at baseline, 12, 26, and 52 weeks, with measurements of costs including medical and non-medical costs as recorded by patients and healthcare providers. Quality-adjusted life-years (QALYs) were estimated using the EuroQol 5 dimensions 5 levels (EQ-5D-5L) and EuroQol Visual Analogue Scale (EQ-VAS). Costs and QALY differences were analysed according to the intention-to-treat principle using cost-effectiveness acceptability curves.

resultsThe 1 year societal costs were non-significantly in favour of the usual care group, with a small difference of €180 [95% confidence interval (CI) €-4493 to €4852]. The QALYs were non-significantly in favour of the intervention group, by 0.02 according to the EQ-5D-5L (95% CI -0.05 to 0.09) and by 0.04 according to the EQ-VAS (95% CI 0.00 to 0.08). For a willingness-to-pay threshold of €50 000 per QALY, the intervention was the cost-effective strategy with 60% certainty.

conclusionThis economic evaluation showed no clear economic preference for either group, as the intervention costs were higher in the intervention group, but partly compensated by other cost savings and improved QALYs. Despite severe RA, patients had better clinical outcomes compared with usual care, suggesting no economic reasons to refrain from exercise therapy. TRIAL REGISTRATION NUMBER: Netherlands Trial Register NL8235, included in the International Clinical Trial Registry Platform (ICTRP) (https://trialsearch.who.int/Trial2.aspx?TrialID=NL8235).

Indexed as

Arthritis, RheumatoidCost-Benefit AnalysisExercise TherapyActivities of Daily LivingAgedFemaleHumansMaleMiddle AgedQuality-Adjusted Life YearsSeverity of Illness Index

Identifiers

PMID39351606
PMCPMC11854037

What OpenQuestion holds

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Registered trials

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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.