Impact of immunobiological drugs and coronary heart disease in the evolution of patients with rheumatoid arthritis: a cost-effectiveness

Abstract

Targets Patients: Patients with a diagnosis of rheumatoid arthritis according to the criteria of the Brazilian Consensus of Rheumatoid arthritis of the Brazilian Society of Rheumatology, in 18 years, of both sex treated with drugs modifying rheumatoid arthritis immunobiological agents and anti- TNF alpha that have evolved with atherosclerotic cardiovascular disease.Care Context: Patients treated in outpatient and / or hospital for treatment and monitoring of rheumatoid arthritis or hospital for treatment of acute myocardial infarction submitted to the intervention of surgical or percutaneous revascularization.Interventions studied: Use agent immunobiological anti-TNF alpha in the treatment of rheumatoid arthritis.Interventions controls: Proposal therapy with or without a DMARD `s modifying drugs rheumatoid arthritis, as Brazilian consensus of rheumatoid arthritis.Main Outcome: Impact of atherosclerotic cardiovascular disease in evaluating the cost-effectiveness of rheumatoid arthritis treated with anti-TNF agents immunobiological alpha.Secondary Outcomes: To evaluate the prevalence of ischemic cardiovascular events in both intervention groups, evaluate the costs of drug therapy for rheumatoid arthritis and treatment costs of ischemic cardiac event.Outcome measures: The economic analysis will be conducted through analysis of cost-effectiveness. To measure the occurrence of cardiovascular events will be used to incidence of acute myocardial infarction among those using drugs modifying rheumatoid arthritis or use of anti - TNF alpha during the study period.Temporal horizon: For the outcome of the appeal will be evaluated cardiac cases of acute myocardial infarction in a time horizon of 5 years.Studies involved in the project: Study randomized, double-blind, placebo-controlled, cohort study, pharmacoeconomic study, study registry biological treatment meta-analysis study, a population-based study and study systemic review of the literature. (AU)