TOPLINE:
Early detection and treatment of rheumatoid arthritis (RA; within 12 weeks of symptom onset) results in lower treatment-related costs over 5 years compared with later diagnosis.
METHODOLOGY:
- The study enrolled 431 patients in the Leiden Early Arthritis Clinic at Leiden University Medical Center, Leiden, the Netherlands.
- Symptom duration was defined as time between symptom onset and first clinic visit.
- Early treatment was defined as a symptom duration of under 12 weeks, and later treatment defined as symptom duration over 12 weeks.
- Prescription data from patient records and 2022 disease-modifying antirheumatic drug prices (including biologics) was used to determine overall costs over 5 years.
- Autoantibody-negative and autoantibody-positive RA were studied separately because of possible differences in disease severity.
TAKEAWAY:
- For the 165 patients with autoantibody-negative RA, late treatment was associated with 316% higher costs over 5 years than early treatment (€4856/$5292 vs €1159/$1263)
- For antibody-positive RA, costs were 19% higher in the late-treatment group.
- In the 43 patients with antibody-positive RA only prescribed biologics, costs were 46% higher for those with delayed treatment.
IN PRACTICE:
“This is the first study showing the effect of early diagnosis and treatment on treatment-related costs,” wrote the authors. “When RA is detected within 12 weeks after symptom onset, treatment-related costs seem to be lower.”
SOURCE:
The study was led by Elise van Mulligen, PhD, Department of Rheumatology, Leiden University Medical Center. It was published online in Annals of the Rheumatic Diseases.
LIMITATIONS:
The division of symptom duration by 12 weeks was “arbitrary.” Baseline characteristics, though similar, showed differences for inflammatory markers in autoantibody-positive and autoantibody-negative RA. Thirty seven patients were lost to follow-up, which could induce attrition bias, though the percentage of these patients in the early- and late-treatment groups was similar.
DISCLOSURES:
This study was funded by ZonMw, a Dutch organization for healthcare research. The authors declared no relevant conflicts of interest.
A version of this article appeared on Medscape.com.