Costs and course of disease and function in early rheumatoid arthritis: a 3-year follow-up (the Swedish TIRA project)
2006 (English)In: Rheumatology, ISSN 1462-0324 (print), 1462-0332 (online), Vol. 45, no 3, 325-331 p.Article in journal (Refereed) Published
Objective. To calculate direct and indirect costs and to studydisease activity and functional ability over 3 yr in early rheumatoidarthritis (RA).
Methods. Three hundred and three patients with early (≤1 yr)RA were recruited during a period of 27 months (1996–1998).Data were recorded during 3 yr to assess disease activity, functionalability, medication, health-care utilization and days lost fromwork.
Results. Within 3 months, improvements were seen regarding allrecorded variables assessing disease activity and functionalability, but 15% had sustained high or moderate disease activitythroughout the study period. Indirect costs exceeded directcosts in all 3 yr. The average direct costs were € 3704 (US$3297) in year 1 and € 2652 (US$ 2360) in year 3. All costs decreased,except those for medication and surgery. Compared with men,women had more ambulatory care visits and used more complementarymedicine. The indirect costs were € 8871 (US$ 7895) in year 1and remained essentially unchanged; this was similar for bothsexes. Almost 50% were on sick leave or early retirement atinclusion. Sick leave decreased but was offset by an increasein early retirement. The 14 patients who eventually receivedTNF inhibitors incurred higher costs even before prescriptionof anti-TNF therapy.
Conclusion. Disease activity and functional ability improvedwithin 3 months after diagnosis of early RA. Direct costs decreased,except for medication and surgery. Indirect costs remained unchanged.Fifteen per cent of the patients had high or moderate diseaseactivity in all 3 yr, indicating a need for more aggressiveearly anti-rheumatic therapy.
Place, publisher, year, edition, pages
2006. Vol. 45, no 3, 325-331 p.
Rheumatoid arthritis, Costs, Disease course
National CategoryMedical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-14284DOI: 10.1093/rheumatology/kei157OAI: oai:DiVA.org:liu-14284DiVA: diva2:23089