Study: Cheaper rheumatoid arthritis drugs as effective as expensive option

UNMC’s James O’Dell, M.D., is a co-author of a study that shows a rheumatoid arthritis (RA) treatment that costs $1,000 annually is as effective as another common treatment that costs as much as $25,000 each year.

Researchers found the cheaper “triple therapy,” a combination of three drugs (methotrexate, sulfasalazine and hydroxychloroquine), works as well as a more expensive combination of two drugs (methotrexate and etanercept). Etanercept is part of a class of drugs known as biologics.

John Weyent, right, of Omaha laughs with James O’Dell, M.D., during a news conference at UNMC. Weyent participated in a study that was co-authored by Dr. O’Dell that showed a $1,000 rheumatoid arthritis treatment is as effective as a therapy that costs as much as $25,000. (Andrew E. Nelson, UNMC public relations)

“Before the study, there was a general belief that biologics have significantly more potency, but this study has proven that not to be the case in this patient population,” said Dr. O’Dell, chief of the UNMC and Omaha VA sections of rheumatology and immunology.

Triple therapy became popular in 1996 when UNMC researchers published a landmark study in the New England Journal of Medicine.

Results of the most recent study will be presented Tuesday at the American College of Rheumatology Annual Scientific Meeting in Philadelphia.

About 2.5 million Americans have RA, a chronic disease that causes pain, stiffness, swelling and limitation in motion and function of multiple joints.

The double-blind study evaluated 755 newly-diagnosed patients over two years. Neither patients nor their physicians knew which regimen was administered.

“This study was the first to directly compare these two therapies, and data from this investigator-initiated study provides critical information for researchers,” said Larry Moreland, M.D., of the University of Pittsburgh Medical Center and lead author of the study.

The cost difference in the therapies stems from different manufacturing process. The triple-therapy drugs are made with synthetics whereas biologics require sophisticated production and monitoring techniques.

More comparison studies of the therapies should be conducted, Dr. O’Dell said, because in some cases, possible side effects and other issues related to each treatment may make one the right choice regardless of price.

“We are looking for the safest and most effective medications. If we can do that with cheaper medications, then we’re all better off,” Dr. O’Dell said.

Disclosure of interests statement: Dr. O’Dell has served as a consultant for Amgen, the maker of Enbrel.