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csDMARDS for Rheumatoid Arthritis

Last updated: October 9, 2019
Project Number: HE0029-000
Product Line: Technology Review
Research Type: Drug
Result type: Report

Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disease characterized by inflammation of the synovial lining of the joints, tendons, and periarticular structures. Definitive treatments that have disease-modifying potential include glucocorticoids, conventional synthetic disease-modifying antirheumatic drugs ([csDMARDs], such as methotrexate, sulfasalazine, hydroxychloroquine, and leflunomide), biologic DMARDs (tumour necrosis factor [TNF] inhibitors and non-TNF inhibitors), or targeted synthetic DMARDs ([tsDMARDs], such as the Janus kinase (JAK) inhibitors tofacitinib and baricitinib). The use of DMARDs leads to an improvement in pain and function for patients with RA, as well as additional long-term outcomes such as less disease progression and less disability.

There is a need to understand the comparative effectiveness of the different drug classes before determining which drug within a drug class is the most clinically effective and cost-effective alternative. This project will determine if there are significant differences in clinical effectiveness and cost-effectiveness between the double and triple csDMARDs combinations.

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