Comparison of treatment outcome in Rheumatoid Arthritis patients treated with single and two DMARDs in combination with Corticosteroids

Musculoskeletal disorders impose a considerable burden upon society due to long-term morbidity, disability and treatment costs. Among Musculoskeletal diseases, Rheumatoid Arthritis encumbers patients with a significantly higher individual economic burden. The present study seeks to analyse the Pharmacoeconomics aspects of Rheumatoid Arthritis (RA) and to assess the Quality of Life (QoL) of patients treated with the selected combination of drugs used in the therapy of Rheumatoid Arthritis. The treatment costs vary based on the use of single DMARD, combination DMARDs, biological agents, etc. The design of the study was a prospective and observational study for a period of 12 months in a tertiary care referral hospital in Kerala. All the Rheumatoid Arthritis patients who attended the Rheumatology OPD, with 3 months follow-up and who satisfied the inclusion criteria were included in the study. The Cost effectiveness analysis was done by taking the HAQ - DI score as a measure of effectiveness and the improvement in Quality of Life was measured by using the disease activity parameters like Swollen Joint Count, Tender Joint Count, ESR, duration of morning stiffness, etc. Three groups of Drugs were selected for this study, namely, Group 1: Methotrexate + Corticosteroids, Group 2: Hydroxychloroquine + Corticosteroids, and Group 3: Methotrexate + Hydroxychloroquine + Corticosteroids. It has been observed that the maximum improvement in Quality of Life and the least Average Cost Effective Ratio were obtained in the case of the combination of Drugs in Group 3. The highest Average Cost Effective Ratio was observed in the case of Group 2 Drugs.

Author(s): M. A. Kuriachan, K.G. Revikumar, Andreena Jolly

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