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1. German guidelines for the sequential medical treatment of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs

Author

Albrecht, Katinka, Krüger, Klaus, Wollenhaupt, Jürgen, Alten, Rieke, Backhaus, Marina, Baerwald, Christoph, Bolten, Wolfgang, Braun, Jürgen, Burkhardt, Harald, Burmester, Gerd R., Gaubitz, Markus, Gause, Angela, Gromnica-Ihle, Erika, Kellner, Herbert, Kuipers, Jens, Krause, Andreas, Lorenz, Hans-Martin, Manger, Bernhard, Nüßlein, Hubert, Pott, Hans-Georg, Rubbert-Roth, Andrea, Schneider, Matthias, Specker, Christof, Schulze-Koops, Hendrik, Tony, Hans-Peter, Wassenberg, Siegfried, and Müller-Ladner, Ulf

Published
2014
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2. Cost-effective Tapering Algorithm in Patients with Rheumatoid Arthritis: Combination of Multibiomarker Disease Activity Score and Autoantibody Status

Author

Hagen, Melanie, primary, Englbrecht, Matthias, additional, Haschka, Judith, additional, Reiser, Michaela, additional, Kleyer, Arnd, additional, Hueber, Axel, additional, Manger, Bernhard, additional, Figueiredo, Camille, additional, Cobra, Jayme Fogagnolo, additional, Tony, Hans-Peter, additional, Finzel, Stephanie, additional, Kleinert, Stefan, additional, Wendler, Jörg, additional, Schuch, Florian, additional, Ronneberger, Monika, additional, Feuchtenberger, Martin, additional, Fleck, Martin, additional, Manger, Karin, additional, Ochs, Wolfgang, additional, Lorenz, Hans-Martin, additional, Nüsslein, Hubert, additional, Alten, Rieke, additional, Henes, Jörg, additional, Krüger, Klaus, additional, Schett, Georg, additional, and Rech, Jürgen, additional

Published
2018
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3. Cost-effective Tapering Algorithm in Rheumatoid Arthritis Patients: Combination of Multibiomarker Disease Activity Score and Autoantibody Status.

Author

Hagen, Melanie, Englbrecht, Matthias, Haschka, Judith, Reiser, Michaela, Kleyer, Arnd, Hueber, Axel, Manger, Bernhard, Figueiredo, Camille, Fogagnolo Cobra, Jayme, Tony, Hans-Peter, Finzel, Stephanie, Kleinert, Stefan, Wendler, Jörg, Schuch, Florian, Ronneberger, Monika, Feuchtenberger, Martin, Fleck, Martin, Manger, Karin, Ochs, Wolfgang, and Lorenz, Hans-Martin

Published
2019
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5. Cost-effective Tapering Algorithm in Patients with Rheumatoid Arthritis: Combination of Multibiomarker Disease Activity Score and Autoantibody Status

Author

Hagen, Melanie, Englbrecht, Matthias, Haschka, Judith, Reiser, Michaela, Kleyer, Arnd, Hueber, Axel, Manger, Bernhard, Figueiredo, Camille, Cobra, Jayme Fogagnolo, Tony, Hans-Peter, Finzel, Stephanie, Kleinert, Stefan, Wendler, Jörg, Schuch, Florian, Ronneberger, Monika, Feuchtenberger, Martin, Fleck, Martin, Manger, Karin, Ochs, Wolfgang, Lorenz, Hans-Martin, Nüsslein, Hubert, Alten, Rieke, Henes, Jörg, Krüger, Klaus, Schett, Georg, and Rech, Jürgen

Abstract

Objective.To analyze the effect of a risk-stratified disease-modifying antirheumatic drug (DMARD)–tapering algorithm based on multibiomarker disease activity (MBDA) score and anticitrullinated protein antibodies (ACPA) on direct treatment costs for patients with rheumatoid arthritis (RA) in sustained remission.Methods.The study was a posthoc retrospective analysis of direct treatment costs for 146 patients with RA in sustained remission tapering and stopping DMARD treatment, in the prospective randomized RETRO study. MBDA scores and ACPA status were determined in baseline samples of patients continuing DMARD (arm 1), tapering their dose by 50% (arm 2), or stopping after tapering (arm 3). Patients were followed over 1 year, and direct treatment costs were evaluated every 3 months. MBDA and ACPA status were used as predictors creating a risk-stratified tapering algorithm based on relapse rates.Results.RA patients with a low MBDA score (< 30 units) and negative ACPA showed the lowest relapse risk (19%), while double-positive patients showed high relapse risk (61%). In ACPA-negative and MBDA-negative (< 30 units), and ACPA or MBDA single-positive (> 30 units) groups, DMARD tapering appears feasible. Considering only patients without flare, direct costs for synthetic and biologic DMARD in the ACPA/MBDA-negative and single positive groups (n = 41) would have been €372,245.16 for full-dose treatment over 1 year. Tapering and stopping DMARD in this low-risk relapse group allowed a reduction of €219,712.03 of DMARD costs. Average reduction of DMARD costs per patient was €5358.83.Conclusion.Combining MBDA score and ACPA status at baseline may allow risk stratification for successful DMARD tapering and cost-effective use of biologic DMARD in patients in deep remission as defined by the 28-joint count Disease Activity Score using erythrocyte sedimentation rate.

Published
2019
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6. German guidelines for the sequential medical treatment of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs

Author

Albrecht, Katinka t, Krueger, Klaus, Wollenhaupt, Juergen, Alten, Rieke, Backhaus, Marina, Baerwald, Christoph, Bolten, Wolfgang, Braun, Juergen, Burkhardt, Harald, Burmester, Gerd R., Gaubitz, Markus, Gause, Angela, Gromnica-Ihle, Erika, Kellner, Herbert, Kuipers, Jens, Krause, Andreas, Lorenz, Hans-Martin, Manger, Bernhard, Nuesslein, Hubert, Pott, Hans-Georg, Rubbert-Roth, Andrea, Schneider, Matthias, Specker, Christof, Schulze-Koops, Hendrik, Tony, Hans-Peter, Wassenberg, Siegfried, Mueller-Ladner, Ulf, Albrecht, Katinka t, Krueger, Klaus, Wollenhaupt, Juergen, Alten, Rieke, Backhaus, Marina, Baerwald, Christoph, Bolten, Wolfgang, Braun, Juergen, Burkhardt, Harald, Burmester, Gerd R., Gaubitz, Markus, Gause, Angela, Gromnica-Ihle, Erika, Kellner, Herbert, Kuipers, Jens, Krause, Andreas, Lorenz, Hans-Martin, Manger, Bernhard, Nuesslein, Hubert, Pott, Hans-Georg, Rubbert-Roth, Andrea, Schneider, Matthias, Specker, Christof, Schulze-Koops, Hendrik, Tony, Hans-Peter, Wassenberg, Siegfried, and Mueller-Ladner, Ulf

Abstract

The German Society of Rheumatology approved new German guidelines for the sequential medical treatment of rheumatoid arthritis (RA) based on the European League Against Rheumatism (EULAR) recommendations for the management of RA published in 2010. An update of the EULAR systematic literature research was performed in Medline, Embase, and Cochrane databases. Meta-analyses, controlled trials, cohort studies, and registry data addressing traditional and biologic disease-modifying antirheumatic drugs, glucocorticoids, and treatment strategies published between January 2009 and August 2011 were included. Two reviewers independently evaluated and compared the additional data that had been published after the time limit set by the EULAR recommendations. A national guideline working group developed an adapted set of recommendations. The new German guidelines were accepted by vote using an informal Delphi approach. Twelve recommendations and the resulting updated treatment algorithm were developed and approved as a practical orientation for rheumatologists. These recommendations are based on a successive treatment with traditional and biologic disease-modifying drugs depending on the individual progress of the disease and distinct patient characteristics. The German guidelines have been developed on the basis of the internationally well-recognized EULAR recommendations. In addition, more recent evidence from a systematic literature research was considered. They have been developed and approved by a group of national experts aiming at guidance for rheumatologists to reach best medical practice.

Published
2014

8. German guidelines for the sequential medical treatment of rheumatoid arthritis with traditional and biologic disease-modifying antirheumatic drugs

Author

Albrecht, Katinka, primary, Krüger, Klaus, additional, Wollenhaupt, Jürgen, additional, Alten, Rieke, additional, Backhaus, Marina, additional, Baerwald, Christoph, additional, Bolten, Wolfgang, additional, Braun, Jürgen, additional, Burkhardt, Harald, additional, Burmester, Gerd R., additional, Gaubitz, Markus, additional, Gause, Angela, additional, Gromnica-Ihle, Erika, additional, Kellner, Herbert, additional, Kuipers, Jens, additional, Krause, Andreas, additional, Lorenz, Hans-Martin, additional, Manger, Bernhard, additional, Nüßlein, Hubert, additional, Pott, Hans-Georg, additional, Rubbert-Roth, Andrea, additional, Schneider, Matthias, additional, Specker, Christof, additional, Schulze-Koops, Hendrik, additional, Tony, Hans-Peter, additional, Wassenberg, Siegfried, additional, and Müller-Ladner, Ulf, additional

Published
2013
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