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Executive summary

Rheumatoid arthritis (RA) is a common inflammatory condition that typically causes a symmetrical chronic arthritis that causes joint pain, swelling and in some cases a systemic illness. The cause of RA is unknown, but important genetic influences are recognised. The goal of treatment is to achieve remission if patients present with early disease. In later disease, key goals are to control pain and inflammation and thereby reduce functional limitations and the risk of permanent joint damage.

Background

Rheumatoid arthritis (RA) is a common inflammatory condition that typically causes a symmetrical chronic arthritis that causes joint pain, swelling and in some cases a systemic illness. The cause of RA is unknown, but important genetic influences are recognised. The goal of treatment is to achieve remission if patients present with early disease. In later disease, key goals are to control pain and inflammation and thereby reduce functional limitations and the risk of permanent joint damage.

Assessment of clinical effectiveness

Bibliographic databases: Cochrane Library (CENTRAL) 2009 Issue3, MEDLINE (Ovid) 1,950 to July week 1 2009, MEDLINE In-Process & Other Non-Indexed Citations (Ovid) 13 July 2009, EMBASE (Ovid) 1980–2009 week 28. Searches were based on index and text words that encompassed the condition, RA, and the interventions ADA, IFX, ETN, RTX and ABT.

Assessment of cost-effectiveness

Articles on the cost and cost-effectiveness of drugs for RA after the failure of a TNF inhibitor were identified from the searches for clinical effectiveness. In addition, the NHS Economic Evaluation Database (NHS EED), Cochrane Library 2009 (Issue 3) and the internet sites of national economic units were searched.

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