BACKGROUND

Active radiographic axial spondyloarthritis (r-AxSpA) is a chronic inflammatory disease that often results in work disability and productivity loss. Although several biologics are currently approved in Russia to treat r-AxSpA, the costs of therapy remain substantial.

OBJECTIVES

To determine the number of adults with active r-AxSpA needed to treat (NNT) to achieve ASAS 20/40 and the incremental 16-weeks and one-year costs per responder (CpR) for each drug analyzed.

METHODS

The study is based on the results of a systematic review and network meta-analysis comparing the effectiveness of biologics: netakimab, ixekizumab, secukinumab, adalimumab, infliximab, etanercept, golimumab and certolizumab pegol, in adults with active r-AxSpA in Russia. We calculated the risk differences between drugs and placebo, the ASAS 20/40 NNTs, 16-weeks and one-year CpRs.

RESULTS

The lowest ASAS 20 NNTs were obtained for IL-17 inhibitors: netakimab and ixekizumab as well as TNF-α inhibitor infliximab. Higher NNT values were demonstrated by adalimumab, golimumab, etanercept, and secukinumab. It requires to treat less than 2 patients with netakimab, and less than 3 patients with either infliximab or ixekizumab to achieve one ASAS 40 response. At least 1 out of 4 patients will achieve ASAS 40 following adalimumab, etanercept 50 mg, certolizumab pegol 400 mg or golimumab treatment, while secukinumab, certolizumab pegol 200 mg or etanercept 25 mg may require more patients to be treated. Netakimab demonstrated the lowest 16-weeks and one-year CpRs. Ixekizumab improved its ranking of costs per ASAS 40 responder due to lower corresponding NNT value. Secukinumab and certolizumab pegol showed the highest CpRs between all biologics. These drugs are the least cost-effective treatment options.

CONCLUSIONS

This study complements the systematic review and network meta-analysis of relative effectiveness of biologics in adults with active r-AxSpA in Russia. The results may be a useful tool for treatment decision-making.