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Table 1 Overview of bDMARDs for AIRD, loading schedules (if applicable) and associated costs

From: The pharmacological and clinical aspects behind dose loading of biological disease modifying anti-rheumatic drugs (bDMARDs) in auto-immune rheumatic diseases (AIRDs): rationale and systematic narrative review of clinical evidence

Drug classDrugTerminal halve lifeAuthorised with dose-loading in AIRDs / other disease?Loading scheduleCost per patient year with loading doseaCost per patient year without loading doseaEuro/ % increase medication costs due to dose-loading for full year use
TNFiAdalimumab14 daysNo / YesNA   
 Certolizumab14 daysYes / NA400 mg weeks 0,2,4, instead of 200 mg€14,459€12,965€1495 / 11.5%
 Etanercept3 daysNo / YesNA   
 Golimumab12 daysNo / YesNA   
 Infliximab (RA)9 daysYes / Yes3 mg/kg weeks 0,2,6 and 14, instead of 8 weeklyb€12,940€11,323€1617 / 12.4%
 Infliximab (PsA/axSpA)9 daysYes / Yes5 mg/kg weeks 0,2,6 and 14, instead of 8 weeklyb€17,254€15,097€2157 / 12.5%
Anti-CD20Rituximab6–62 daysNo / NoNA   
Anti CD80/86Abatacept i.v.14 daysYes / No750 mg weeks 0,2,4 instead of weeks 0,4c€15,996€14,853€1143 / 7.1%
 Abatacept s.c.14 daysYes / NAStart with 750 mg i.v. instead of once weekly scc€15,199€14,056€1143 / 7.5%
IL-1 receptor antagonistAnakinra5 hNo / NoNA   
Anti-IL6 receptorSarilumab9 days (initial)No / NoNA   
 Tocilizumab i.v.3 daysNo / NoNA   
 Tocilizumab s.c.13 daysNo / NoNA   
Anti-IL-17ASecukinumab 150 mg27 daysYes / YesWeeks 0,1,2,3,4, instead of monthly€9357€7486€1871 / 20%
 Secukinumab 300 mg27 daysYes / YesWeeks 0,1,2,3,4, instead of monthly€18,714€14,972€3742 / 20%
 Ixekizumab13 daysYes / Yes160 mg instead of 80 mg week 0€16,116€14,965€1151 / 7.1%
Anti-IL-12/23Ustekinumab21 daysYes / YesAdditional injection at week 4c€16,023€12,819€3204 / 20%
  1. awww.medicijnkosten.nl, costs per patient year in the Netherlands
  2. b 3 mg/ and 5 mg/kg rounded to 3*100 mg and 4*100 mg vials per infusion
  3. c of the three weight based doses the middle dose of 750 mg was used
  4. c 45 mg (< 100 kg bodyweight) was used
  5. Abbreviations: i.v. Intravenous, s.c. Subcutaneous, TNFi TNF inhibitor, AIRDs Auto-Immune Rheumatic Disease, NA Not Applicable, AIRD Auto-immune Rheumatic Diseases