TY - JOUR AU - Chen, Y AU - Jobanputra, P AU - Barton, P AU - Jowett, S AU - Bryan, S J2 - Health Technology Assessment JO - Health Technology Assessment TI - A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness PY - 2006 VL - 10 IS - 42 DO - 10.3310/hta10420 DA - 2006/11/01 UR - http//journalslibrary.nihr.ac.uk/hta/hta10420 AB - OBJECTIVES This report reviews the clinical effectiveness and cost-effectiveness of adalimumab, etanercept and infliximab, agents that inhibit tumour necrosis factor-alpha (TNF-alpha), when used in the treatment of rheumatoid arthritis (RA) in adults.DATA SOURCES Electronic databases were searched up to February 2005.REVIEW METHODS Systematic reviews of the literature on effectiveness and cost-effectiveness were undertaken and industry submissions to the National Institute for Health and Clinical Excellence (NICE) were reviewed. Meta-analyses of effectiveness data were also undertaken for each agent. The Birmingham Rheumatoid Arthritis Model (BRAM), a simulation model, was further developed and used to produce an incremental cost-effectiveness analysis.RESULTS Twenty-nine randomised controlled trials (RCTs), most of high quality, were included. The only head-to-head comparisons were against methotrexate. For patients with short disease duration (