BACKGROUND

There are several biologics approved in Russia to treat active radiographic axial spondyloarthritis (r-AxSpA). However, published clinical trial results differ in terms of placebo response. Along with significant financial burden of therapy, it poses a challenge to treatment decision-making. Number needed to treat (NNT) as a measure to compare the benefits of various treatments over a baseline risk helps to incorporate efficacy results into clinical practice.

OBJECTIVES

To evaluate and compare NNTs for achieving BASDAI 50 and costs per responder (CpR) among biologics in adults with active r-AxSpA in Russia.

METHODS

NNT values for BASDAI 50 were calculated as the inverse of risk differences between active treatments and placebo. Risk differences were obtained from the results of a systematic review and network meta-analysis evaluating effectiveness of biologics to treat r-AxSpA in Russia: netakimab, ixekizumab, adalimumab, infliximab, etanercept, and certolizumab pegol. CpR were calculated for 16-weeks and 1-year treatment periods. The upper limits of 95% credible intervals for NNT and CpR values were used for interpretation and conclusions.

RESULTS

IL-17 inhibitor netakimab demonstrated the lowest NNT: it requires to treat no more than 3 patients to achieve at least one BASDAI 50 response. In contrast, infliximab, etanercept 50 mg, adalimumab, ixekizumab, and certolizumab pegol may require from 7 to 16 patients. The highest NNT was obtained for etanercept 25 mg (more than 104 patients). Netakimab also showed the lowest CpRs for both treatment periods followed by adalimumab for 16-weeks CpR and infliximab for one-year CpR. The highest CpR was attributed to etanercept 25 mg.

CONCLUSIONS

The analyses resulted in netakimab being the most cost-effective treatment option, while etanercept 25 mg was the least cost-effective among biologics to treat active r-AxSpA in Russia.