New RA Drugs May Reduce Hospital Stays

TNF inhibitor use for rheumatoid arthritis may reduce hospital admissions and musculoskeletal surgeries

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Patients with rheumatoid arthritis are admitted to hospitals for a number of reasons. They may need surgery, or the inflammation caused by their disease may lead to health problems in other organs.

Treating rheumatoid arthritis with anti-tumor necrosis factor drugs may reduce the need for hospitalization and surgery, according to a recent study.

In other words, these researchers believe the savings from spending fewer days in the hospital may be higher than the costs of using anti-TNF drugs. As an added bonus, anti-TNFs actually help patients control their arthritis symptoms.

"Talk to a rheumatologist to determine the best treatment."

These findings were made by Leonard C. Harty, MD, MRCPI, of St. Vincent's University Hospital in Dublin, Ireland, and colleagues.

If rheumatoid arthritis goes untreated, patients can develop permanent joint damage and disability. For this reason, doctors often prescribe disease-modifying anti-rheumatic drugs (DMARDs) right off the bat.

When patients do not respond well to DMARDs, doctors may prescribe anti-TNF drugs, which have been shown to significantly reduce symptoms of rheumatoid arthritis.

While anti-TNFs are effective drugs, they also come with a high price tag. According to the California-based Autoimmunity Research Foundation, some of these drugs can cost nearly $5,000 for one treatment. Due to these high costs, there has been much debate about whether the benefits of anti-TNF drugs outweigh the costs.

To shed light on this debate, Dr. Harty and colleagues studied the number of days patients spent in the hospital and the number of musculoskeletal surgeries among rheumatoid arthritis patients treated with anti-TNF drugs.

The researchers found that the number of anti-TNF prescriptions increased 156 percent per year. In 2000, 2,389 units of anti-TNFs were prescribed. By 2010, that number increased to 116,747 units.

The increase in anti-TNF prescriptions was linked to a decrease in the number of days arthritis patients spent in hospitals. More specifically, there was a 13 percent drop in hospital admissions.

The decrease in hospital days may have led to large savings in medical costs of about €16,000,000 (about $20,451,200).

In addition, the researchers found a 47 percent drop in musculoskeletal surgeries from 2002 to 2010. This decrease in surgeries was linked to increased use of anti-TNF drugs among patients with rheumatoid arthritis.

According to Dr. Harty, the proper use of anti-TNF drugs can maintain patients' ability to function and may ultimately lead to health care savings that surpass the cost of the drugs while providing greater benefits to patients' health.

Anti-TNFs are part of a class of drugs called biologics. It was only in the last decade that these drugs were developed.

"There is no doubt that the advent of the biologic era has significantly improved health-related outcomes in patients with rheumatoid arthritis," said Professor Oliver FitzGerald of St. Vincent's University Hospital and co-investigator of the study.

The researchers noted that anti-TNF use may not be the only reason patients had better outcomes. Improved use of DMARDs and prevention of other health problems may have played a role.

For their study, Dr. Harty and colleagues looked at records from 57 hospitals in Ireland. They found records for 57,774 inpatients with rheumatoid arthritis.

Professor FitzGerald disclosed potential conflicts of interest with Abbott Immunology Pharmaceuticals and Bristol-Myers Squibb.

The study was presented at the American College of Rheumatology's Annual Meeting. Therefore, the research has yet to be peer-reviewed for publication in a scientific journal. 

Reviewed by: 
Review Date: 
November 14, 2012
Last Updated:
November 21, 2012