Evidence map›Paper›PMID 39982592›Full record

ArticleClinical rheumatology2025

Sequential biologic therapy in the treatment of active psoriatic arthritis in China: a cost-effectiveness analysis.

Ouyang Xie, Meiyu Wu, Andong Li, Kehui Meng, Heng Xiang, Chongqing Tan, Liubao Peng, Yan Ge, Xiaomin Wan

Abstract read
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In one paragraph

Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
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

9 authors.

Ouyang XieDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Meiyu WuDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Andong LiDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Kehui MengDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Heng XiangDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Chongqing TanDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Liubao PengDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
Yan GeDepartment of Rheumatology and Immunology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China. geyan2003@csu.edu.cn.
Xiaomin WanDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China. wanxiaomin@csu.edu.cn.ORCID http://orcid.org/0000-0001-5315-8141

Funding

Fundamental Research Funds for Central Universities of the Central South University 2024ZZTS0988Hunan Province Science and Technology Innovation Talent Program 2023SK4015Natural Science Foundation of Hunan Province 2023JJ60503
6 · The paper itself

Abstract

objectiveCompared with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biologics are more effective and are recommended to be included in the sequential treatment for psoriatic arthritis (PsA) patients. However, biologics are expensive and the cost-effectiveness of sequential biologic therapy in China remains unknown. The purpose of this study is to evaluate the cost-effectiveness of different sequential treatment option for PsA patients who have not responded to csDMARDs from the perspective of Chinese healthcare system.

methodsWe constructed a discrete event simulation model to evaluate the cost-effectiveness of 7 monotherapy treatments and 32 sequential treatments. In sequential therapy, two different types of biologics were used as first-line and second-line treatments, respectively, with the best supportive care (BSC) as the third-line treatment. The primary outcomes included total treatment costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). One-way and probability sensitivity analyses were performed to explore the uncertainty of our model.

resultsCompared to all other strategies, initiating with secukinumab followed by etanercept (SEC-ETN) provided the highest health benefits. At a willingness-to-pay (WTP) threshold of US $38,161 per QALY, SEC-ETN was the most cost-effective strategy, with an ICER of $20,837 per QALY. One-way sensitivity analysis and probabilistic sensitivity analysis results confirmed the robust of this conclusion.

conclusionsIn China, SEC-ETN may be the most cost-effective strategy for patients who have failed treatment with csDMARDs and have not previously used biologics. The results provide evidence for identifying the optimal biologic treatment strategy for PsA patients in China. Key Points • Compared with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biologics are more effective and are recommended to be included in the sequential treatment for psoriatic arthritis (PsA) patients. However, the cost-effectiveness of sequential biologic therapy in China remains unclear. • At a willingness-to-pay threshold of $38,161, initiating with secukinumab followed by etanercept (SEC-ETN) was cost-effective strategy, outperforming other strategies. • From the perspective of the Chinese healthcare system, the optimal biologic treatment strategy was SEC-ETN in China.

Indexed as

Antirheumatic AgentsArthritis, PsoriaticBiological ProductsBiological TherapyAntibodies, Monoclonal, HumanizedChinaCost-Benefit AnalysisCost-Effectiveness AnalysisEtanerceptFemaleHumansMaleMiddle AgedQuality-Adjusted Life YearsTreatment OutcomeAntibodies, Monoclonal, HumanizedAntirheumatic AgentsBiological ProductsEtanerceptsecukinumabCost-effectiveness analysisDiscrete event simulation modelPsoriatic arthritisSequential biologic treatment

Identifiers

PMID39982592

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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.