New Literature Review Highlights Economic Benefits Associated with Achieving Rheumatoid Arthritis Remission

ABBVie (NYSE: ABBV) today announced the publication of results from a new literature review in Advances in Therapy . The literature review reported that achieving clinical remission in rheumatoid arthritis (RA) is likely to be associated with economic benefits, such as reduced direct and indirect disease-related medical costs compared with other disease activity levels. 1

"People with rheumatoid arthritis not only experience a significant physical and emotional burden, but this chronic, progressive disease is also associated with a substantial financial impact," said Sepideh F. Varon , Vice President, Health Economics and Outcomes Research, Immunology, AbbVie. "In addition to the life-changing impact remission can have on patients' lives, the findings of this new review highlight the direct and indirect cost savings associated with achieving it."

Achieving RA remission was found to provide 19%-52% savings in direct medical costs (e.g., by decreasing outpatient/specialist visits, hospitalizations, medical exams/imaging/laboratory tests, surgery, physiotherapy and orthosis), and 37%-75% savings in indirect costs (e.g., by reducing work productivity loss and work disability). ¹ Patients with sustained disease control also reported fewer disease flares and required less resources for disease management, such as clinic visits, examinations or physiotherapy compared to other disease activity levels. ¹

"It is well established that achieving high remission rates early in the treatment journey can help patients to maintain joint functionality and avoid disability in the long-term. However, this publication has collated new and much needed insights into the economic benefits of achieving remission," said Andrew Ostor , M.D., lead author of the literature review and Consultant Rheumatologist at Cabrini Medical Centre, Melbourne, Australia . "These findings also underscore the importance of the treat-to-target strategy to achieve RA remission, which is also recommended in clinical guidelines."

Clinical remission for RA can be defined as an absence of, or the minimal reoccurrence of, the signs and symptoms of inflammation including joint pain, joint tenderness and morning stiffness. ^2,3 Common assessment criteria for clinical remission are based on Disease Activity Score 28 (DAS28), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), and Boolean criteria. DAS28 represents the most commonly used assessment criteria for clinical remission in daily practice and clinical trials. ^4-7 Remission is defined as achieving certain scores using these assessment criteria (e.g., DAS28˂2.6, SDAI≤3.3, CDAI≤2.8). ⁸

About remission in RA

RA is a chronic condition impacting 23.7 million people worldwide and can have a significant impact on their daily lives. ⁹ RA can cause joint pain, swelling, stiffness and loss of function. ¹⁰ It usually affects the hands, feet and wrists. It can also cause some people to experience problems in other areas of the body, or more general symptoms such as fatigue. ¹⁰ Patients may experience periods where symptoms become worse, known as flare-ups or flares, which can be difficult to predict. ¹⁰

RA is not curable but advances over the past 20 years have made it possible for patients to reach remission – a state where the signs and symptoms of the disease, including joint pain, joint tenderness and morning stiffness, are completely absent or rarely occur. ¹¹ This can allow patients to participate in regular daily activities, like returning to work, taking the kids to school, or going on a hike. Both the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) include remission as a goal in their treatment guidelines. ¹¹

About the literature review ¹

The literature review was conducted by searching the PubMed database (including MEDLINE and PubMed Central) to identify studies that reported economic outcomes by disease activity status in patients with RA, including direct medical costs, indirect costs, healthcare resource use and work productivity. Following the search and abstract and full-text screening, 16 articles were selected for inclusion in the summary. The selected articles spanned several countries, including Austria , Canada , France , Germany , Portugal , the Netherlands and the U.S.

To enable a fair comparison between studies, yearly costs were reported in Euros after adjusting for inflation and currency exchange rates. For studies that did not directly report the cost among patients without remission, the cost was calculated as a weighted average of costs in subgroups without remission (e.g., low disease activity [LDA] and moderate/high disease activity [M/HDA]) based on the sample sizes, when applicable. The time span of cost assessment in the studies included in the literature review ranged from six months to 24 months. Future studies with expanded data collection periods are needed to evaluate how remission impacts healthcare costs in the long term. All studies included in the literature review were observational in nature.

About AbbVie in rheumatology

For more than 20 years, AbbVie has been dedicated to improving care for people living with rheumatic diseases. Our longstanding commitment to discovering and delivering transformative therapies is underscored by our pursuit of cutting-edge science that improves our understanding of promising new pathways and targets in order to help more people living with rheumatic diseases reach their treatment goals. For more information on AbbVie in rheumatology, visit https://www.abbvie.com/our-science/therapeutic-focus-areas/immunology/immunology-focus-areas/rheumatology.html .

About AbbVie

AbbVie's mission is to discover and deliver innovative medicines that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas: immunology, oncology, neuroscience, eye care, virology, women's health and gastroenterology, in addition to products and services across its Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com . Follow @abbvie on Twitter , Facebook , Instagram , YouTube and LinkedIn .

Forward-Looking Statements

Some statements in this news release are, or may be considered, forward-looking statements for purposes of the Private Securities Litigation Reform Act of 1995. The words "believe," "expect," "anticipate," "project" and similar expressions, among others, generally identify forward-looking statements. AbbVie cautions that these forward-looking statements are subject to risks and uncertainties, including the impact of the COVID-19 pandemic on AbbVie's operations, results and financial results, that may cause actual results to differ materially from those indicated in the forward-looking statements. Such risks and uncertainties include, but are not limited to, failure to realize the expected benefits of the Allergan acquisition, failure to promptly and effectively integrate Allergan's businesses, significant transaction costs and/or unknown or inestimable liabilities, potential litigation associated with the Allergan acquisition, challenges to intellectual property, competition from other products, difficulties inherent in the research and development process, adverse litigation or government action, and changes to laws and regulations applicable to our industry. Additional information about the economic, competitive, governmental, technological and other factors that may affect AbbVie's operations is set forth in Item 1A, "Risk Factors," of AbbVie's 2020 Annual Report on Form 10-K, which has been filed with the Securities and Exchange Commission (SEC). AbbVie undertakes no obligation to release publicly any revisions to forward-looking statements as a result of subsequent events or developments, except as required by law.

References   :

1. Ostor, A.J., Sawant, R., Qi, C.Z. et al. Value of Remission in Patients with Rheumatoid Arthritis: A Targeted Review. Adv Ther (2021).
2. American College of Rheumatology. "Rheumatoid Arthritis." Available at: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis . Accessed October 2021 .
3. Arthritis Foundation. "Your RA is in Remission! Now What?" Available at: https://www.arthritis.org/health-wellness/treatment/treatment-plan/disease-management/your-ra-is-in-remission!-now-what . Accessed October 2021 .
4. Canhao, H., et al., Common Evaluations of Disease Activity in Rheumatoid Arthritis Reach Discordant Classifications across Different Populations. Front Med (Lausanne), 2018. 5: p. 40.
5. Fransen, J. and P.L. van Riel, The Disease Activity Score and the EULAR response criteria. Rheum Dis Clin North Am, 2009. 35(4): p. 745-57, vii-viii.
6. Gul, H.L., et al., Defining remission in rheumatoid arthritis: does it matter to the patient? A comparison of multi-dimensional remission criteria and patient reported outcomes. Rheumatology (Oxford), 2020. 59(3): p. 613-621.
7. Vander Cruyssen , B., et al., DAS28 best reflects the physician's clinical judgment of response to infliximab therapy in rheumatoid arthritis patients: validation of the DAS28 score in patients under infliximab treatment. Arthritis Res Ther, 2005. 7(5): p. R1063-71.
8. Bykerk, V. and E. M. Massarotti, The new ACR/EULAR remission criteria: rationale for developing new criteria for remission. Rheumatology, 2012. 51(6), pp. vi16–vi20.
9. World Health Organization. The Global Burden of Disease, 2004 Update. Available at: https://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf . Accessed October 2021 .
10. NHS. "Overview Rheumatoid arthritis." Available at: www.nhs.uk/conditions/rheumatoid-arthritis . Accessed October 2021 .
11. Ajeganova S. and Huizinga T., Sustained remission in rheumatoid arthritis: latest evidence and clinical considerations. Ther Adv Musculoskelet Dis. 2017 Oct;9(10):249-262.

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