Effectiveness and Safety of Anti-Tumor Necrosis Factor Drugs in Arthritis: A Rapid Review

Abstract

Background: The World Health Organization suggested that the prevalence of different types of arthritis was between 0.7 and 4.01 in every 1000 children in 2003. With regard to this fact, the present study was aimed to review available evidence on anti-tumor necrosis factor (Anti-TNF) drugs which are prescribed to treat patients suffering from debilitating pain and physical limitations of various forms of arthritis. Methods: A database search of the Cochrane Library was conducted from the beginning of the year 2009 to October 2011. Only the secondary studies that used drug safety, efficacy and cost-effectiveness criteria for comparing biologic agents for the treatment of the most common forms of arthritis were considered in this review. Results were analyzed using qualitative methods. Findings: Using a specific search query, 34 hints were retrieved. After eliminating the irrelevant studies and duplications, 12 articles were entered into the review, based on predetermined criteria. Findings of the 12 selected articles, published between 2009 and 2011, were categorized into safety (3 articles), effectiveness (6 articles), and economic evaluations (3 articles). Conclusion: Anti-TNF drugs can safely provide rapid, significant, and sustained benefits in patients with active rheumatoid arthritis, according to different studies. However, their long-term complications including tuberculosis reactivation, serious infection and chronic heart failure need further investigation. Anti-TNF drugs, particularly etanercept, were effective in treating rheumatoid arthritis, psoriatic arthritis, and psoriatic plaque and efficacious in alleviating the signs and symptoms of early and severe rheumatoid arthritis. Because of the lack of sound and long-term economic data, evidence is insufficient to draw firm conclusions about the comparative cost-effectiveness of these biologics; nevertheless, this review suggests that etanercept is cost-effective in treating the three aforementioned forms of arthritis. Keywords: Rheumatoid arthritis, Anti-rheumatic agents, Tumor necrosis factor receptor, Etanercept