Scots pit Rituxan against anti-TNF therapy

While the U.S. is just beginning to gear up for a comparative-effectiveness research push, a head-to-head trial of rheumatoid arthritis meds is launching in Scotland. Pitting an anti-TNF drug against Rituxan (rituximab), the trial is not only comparing and contrasting the performance of the two drugs. It's also designed to determine whether it's possible to personalize arthritis treatment by matching the appropriate drug to the appropriate patient--before drug therapy ever begins.

Here's the skinny on the trial. It's set to involve some 300 patients who haven't responded well enough to therapy with other drugs such as methotrexate. Some patients will get an unspecified anti-TNF drug--examples include Amgen's (NASDAQ: AMGN)  Enbrel, Johnson & Johnson's (NYSE: JNJ) Remicade and Abbott Laboratories' (NYSE: ABT) Humira--and others will get Roche's (OTC: RHHBY) Rituxan. "We know that both these treatments (anti-TNF and rituximab) may work, but we don't have very good evidence about which works better, or about which offers the NHS better value for money," said a trial description from funder Arthritis Research U.K.

Researchers will also take tissue samples of trial participants, hoping they can identify tissue characteristics that can match patients with the best drug for them.

One thing is different about this head-to-head trial and those that the U.S. will be funding: The open discussion of comparative drug costs. The lead researcher, Dr. Duncan Porter, notes that anti-TNF therapy costs 9,000 pounds to 10,000 pounds a year (about $13,700 to $15,300). Rituxan, by contrast, costs 4,000 pounds to 7,000 pounds a year (about $6,000 to $10,600). If Rituxan proves to be just as effective as the anti-TNF drugs, Scotland's National Health Service could save up to 20 million pounds a year, Porter notes. That's $30 million.

- see the trial description at Arthritis Research U.K.
- get more from Scotsman

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