Determination of clinical outcome and pharmacoeconomics of antirheumatoid arthritis therapy using CDAI, EQ-5D-3L and EQ-VAS as indices of disease amelioration
Journal Title: Asian Pacific Journal of Tropical Disease - Year 2012, Vol 2, Issue 0
Abstract
Objective: Arthritis is a severe debilitating chronic disease. The objective of the present investigation was to evaluate the clinical outcome and cost effectiveness of anti-rheumatoid arthritis regimen for the treatment of arthritis.Methods: The patients were classified into three treatment cohorts on the basis of the treatment regimens prescribed by the physicians. These were group I consisting of patients treated with monotherapy of non-steroidal anti- inflammatory drugs alone, group II consisting of patients treated with disease modifying anti rheumatoid drugs + non-steroidal anti- inflammatory drugs and group III consisting of patients treated with disease modifying anti rheumatoid drugs along with oral Corticosteroids. The patient reported outcome was measured using European questionnaire 5 dimension 3 levels (EQ-5D-3L) and European questionnaire visual analogue scale (EQ-VAS) before and after the treatment regimen. Clinical outcome was measured using Clinical disease activity index (CDAI). The details of costs were recorded by interviewing the patients. Results: The patient reported outcome measured by EQ- 5D-3L and EQ-VAS was significantly improved in patients belonging to group III when compared to group II (P < 0.05) and I (P < 0.001) respectively. The outcomes of CDAI scores demonstrate that the mean change in CDAI levels was 7.04, 12.01 and 16.98 in group I, II and III respectively. Total cost incurred per patient was found to be equal to Rs. 1120 ($19.6) in group I, Rs. 1685 ($29.49) in group II and Rs. 2465 ($43.14) in group III. The ACER was determined as 159.09 in group I, 140.299 in group II and 145.17 in group III.Conclusion:Amelioration of arthritis in clinics can be effectively measured by validated instruments (EQ-5D-3L, EQ-VAS, CDAI) and DMARDs along with NSAIDs are the most cost effective therapy for treatment of arthritis.
Soil transmitted helminths in animals – how is it possible for human transmission?
Objective: To determine the current prevalence of soil transmitted helminths (STH) infections among cats and dogs in an animal shelter. Methods: A total of 442 animal's faecal samples were collected from the selected ani...
Xanthine oxidase inhibitory activity of some Leguminosae plants
Objective: To evaluate the xanthine oxidase inhibitory activity of the methanol leaf extracts of following Cassia javanica, Cynometra ramiflora, Cassia fistula, Senna siamea, Tamarindus indicus, Intsia bijuga, Cassia spe...
Report of congenital colonobladder fitula with atresia ani in a lamb and treatment by surgery
Colonobladder fistula and anal atresia, including congenital malformations in animals, occur due to genetics, environmental factors and vascular insufficiency. A male lamb was brought to a private veterinary clinic in Am...
The aetiology of non-malarial febrile illness in children in the malariaendemic Niger Delta Region of Nigeria
Objective: Febrile illnesses are common in childhood and differentiating the causes could be challenging in areas of perennial malaria transmission. To determine the proportion of nonmalarial febrile illness in children,...
A solitary facial nodular swelling - A case report of intramuscular cysticercosis in buccinator muscle
Taenia solium, the larvae of pork tapeworm can cause the parasitic infection known as cysticercosis. It is commonly seen in developing countries. The condition rarely involves orofacial region and represents a difficulty...