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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 class

Drug

Terminal halve life

Authorised with dose-loading in AIRDs / other disease?

Loading schedule

Cost per patient year with loading dosea

Cost per patient year without loading dosea

Euro/ % increase medication costs due to dose-loading for full year use

TNFi

Adalimumab

14 days

No / Yes

NA

   
 

Certolizumab

14 days

Yes / NA

400 mg weeks 0,2,4, instead of 200 mg

€14,459

€12,965

€1495 / 11.5%

 

Etanercept

3 days

No / Yes

NA

   
 

Golimumab

12 days

No / Yes

NA

   
 

Infliximab (RA)

9 days

Yes / Yes

3 mg/kg weeks 0,2,6 and 14, instead of 8 weeklyb

€12,940

€11,323

€1617 / 12.4%

 

Infliximab (PsA/axSpA)

9 days

Yes / Yes

5 mg/kg weeks 0,2,6 and 14, instead of 8 weeklyb

€17,254

€15,097

€2157 / 12.5%

Anti-CD20

Rituximab

6–62 days

No / No

NA

   

Anti CD80/86

Abatacept i.v.

14 days

Yes / No

750 mg weeks 0,2,4 instead of weeks 0,4c

€15,996

€14,853

€1143 / 7.1%

 

Abatacept s.c.

14 days

Yes / NA

Start with 750 mg i.v. instead of once weekly scc

€15,199

€14,056

€1143 / 7.5%

IL-1 receptor antagonist

Anakinra

5 h

No / No

NA

   

Anti-IL6 receptor

Sarilumab

9 days (initial)

No / No

NA

   
 

Tocilizumab i.v.

3 days

No / No

NA

   
 

Tocilizumab s.c.

13 days

No / No

NA

   

Anti-IL-17A

Secukinumab 150 mg

27 days

Yes / Yes

Weeks 0,1,2,3,4, instead of monthly

€9357

€7486

€1871 / 20%

 

Secukinumab 300 mg

27 days

Yes / Yes

Weeks 0,1,2,3,4, instead of monthly

€18,714

€14,972

€3742 / 20%

 

Ixekizumab

13 days

Yes / Yes

160 mg instead of 80 mg week 0

€16,116

€14,965

€1151 / 7.1%

Anti-IL-12/23

Ustekinumab

21 days

Yes / Yes

Additional 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