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Cost-effectiveness Analysis of Reference Infliximab (Remicade) Compared to its Biosimilar (Remsima) in Iraqi Patients with Rheumatoid Arthritis (Conference Paper )#
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The study objective was to conduct Pharmacoeconomics study (cost-effective analysis) between infliximab reference (Remicade) and its biosimilar (Remsima) in patients with rheumatoid arthritis (RA) in Iraqi hospitals.

This is a retrospective multicenter pharmacoeconomic analysis conducted at two large teaching governmental hospitals in Baghdad, Iraq which provided infliximab to patients with RA. Data were collected from patient’s medical records and face-to-face interviews with the patients from December 2021 to April 2022.

The study included 57 patients with rheumatoid arthritis (RA).  The patients were categorized into two groups according to the type of infliximab they received over 30 weeks: 27 patients received reference infliximab (Remicade) and 30 patients received biosimilar infliximab (Remsima). The two groups had comparable demographic and baseline disease parameters, with a mean age of 49.6 years and a BMI of 30.0. The vast majority of participants were women (82.5%) with low level of formal education (65%). Overall, both infliximab biopharmaceuticals had good effectiveness to reduce the RA disease activity (CDAI) and improve patient quality of life. They both had comparable adverse reactions including UTI, fatigue, and headache. There was no significant difference (P-value >0.05) in disease activity between the two groups according to RA clinical disease activity index (CDAI) score across all three-time measures: before biological therapy, 14 weeks post-therapy and 30 weeks post-therapy.

In 2019, Remicade was slightly more effective and provide better quality of life, but costlier ($41,896 per QALY) compared to Remsima. It was not clear whether the reference biologic (Remicade) or its biosimilar (Remsima) was more cost effective. In 2021, Remicade was more cost effective compared to Remsima because Remicade was less expensive and relatively more effective according to CDAI and EQ-5D-5L scores. Registering and purchasing both reference infliximab and its biosimilar was good idea to keep the competition in the price and maintain infliximab for RA patients. 

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Publication Date
Wed May 24 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Elevated Levels of Sialic Acid and Lipid-Associated Sialic Acid in Plasma of Rheumatoid Arthritis Patients
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 The objective of this study is to evaluate plasma levels of total Sialic acid TSA and Lipid –associated Sialic acid LSA as a marker of Rheumatoid Arthritis AR. Plasma Sialic acid is known as a parameter of inflammation. In the present study, in order to explore the potential role of sialic acid in arthritis rheumatoid, plasma sialic acid levels, plasma LSA and total protein in patients with arthritis rheumatoid were measured. A total 40 patients were compared with 40 healthy control subjects. Plasma TSA, LSA and TP level were determined spectrophotometrically in plasma samples. Plasma Sialic acid levels were significantly increased in RA (88.48±14.15 mg/dl, P<0.05) and LSA level were significantly increased in RA (26.3

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Publication Date
Thu Mar 03 2022
Journal Name
Archives Of Rheumatology
Association of tumor necrosis factor-alpha promoter region gene polymorphism at positions -308G/A, -857C/T, and -863C/A with etanercept response in Iraqi rheumatoid arthritis patients
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Objectives: This study aims to evaluate the association between polymorphisms in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at locations -308G/A, -857C/T, and -863C/A with the tendency of being non-responder to etanercept.

Patients and methods: Between October 2020 and August 2021, a total of 80 patients (10 males, 70 females; mean age: 50 years; range, 30 to 72 years) with rheumatoid arthritis (RA) receiving etanercept for at least six months were included. The patients were divided into two groups responders and non-responders, based on their response after six months of continuous treatment. Following polymerase chain reac

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Publication Date
Sun Jun 08 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The study of tempromandibular joint disorders and anti-cyclic citrullinated peptide antibodies in serum and saliva of patients with rheumatoid arthritis
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Background: Rheumatoid arthritis is an autoimmune disease that affects mainly the synovial membranes and articular structures and is characterized by chronic, systemic inflammation involving multiple joints.Being a synovial joint, the Temporomandibular Joint is subject to the same disorders affecting other synovial joints, including RA.Beside it was considered as a specific serological marker for diagnosing RA disease ,antibodies to cyclic citrullinated peptide have proven to be associated with joints destruction, though; it may play a potential role in the prediction of the disease severity. Materials and Methods: Sixty nine individuals (69) were enrolled in this study, forty nine (49) were patients diagnosed with Rheumatoid Arthritis, a

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Publication Date
Mon Jul 24 2023
Journal Name
Research Journal Of Pharmacy And Technology
Comparison of the effects of Methotrexate and Etanercept on RANKL and OPG as Bone Metabolism Biomarkers in patients with Rheumatoid Arthritis
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Rheumatoid arthritis is an autoimmune diseasecharacterized by chronic inflammationthat affects joints and cartilage. Bone complications such asRA-relatedosteoporosis are one of the most extra-articular manifestations. Many inflammatory mediators are released during RA disease pathophysiology; these mediators stimulate osteoclast genesis of bone by direct effects on RANKL and OPG. The study aimedto measure RANKL, OPG in RA patients treated with Etanercept only and other groups treated with Methotrexate onlyat baseline and after three months to evaluate bone state. An observational case-control prospective study was done on 30 RA patients who received MTX, 30 RA patients who received ETN, and 30 healthy,age-matched control groups. The

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Publication Date
Thu Sep 01 2022
Journal Name
Human Gene
Association of CTLA-4 (+49A/G) polymorphism and susceptibility of developing rheumatoid arthritis in an Iraqi Arab population
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Background: The gene responsible for encoding the protein of cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) has been found to be associated with rheumatoid arthritis (RA) in different ethnic populations. But the association of +49A/G CTLA-4 polymorphism with susceptibility of RA among Iraqi Arab populations has not yet been determined. Methods: One hundred and seventy-eight patients were examined, 67 of them were males (mean age 54.71 ± 10.4 years), while 167 were examined for the control group, of whom 64 were males and the rest were females. CTLA-4 DNA genotyping was carried on to determine the +49 A/G (rs231775) polymorphism using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Enzyme-linked immuno

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Publication Date
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Effectiveness of Deep Brain Stimulation in Iraqi Patients with Parkinson Disease
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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Carotid Intima-Media Thickness in Rheumatoid Arthritis Detected by Doppler Ultrasound
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Background: The excess mortality associated with
rheumatoid arthritis is largely due to
cardiovascular disease. Rheumatoid arthritis is of
primary importance in atherogenesis. The intimamedia thickness of extracranial carotid arteries is a
measurable index of the presence of
atherosclerosis.
Objective: To assess carotid intima-media
thickness in rheumatoid arthritis by Doppler
ultrasound.
Methods: Fifty two Iraqi patients with rheumatoid
arthritis were studied and compared with another
fifty two, healthy individuals matched for age and
sex as a control group. Full history was taken and
complete clinical examination was done for all
individuals in both groups. Rheumatoid arthritis
diagnosis was

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Publication Date
Sat Aug 01 2015
Journal Name
International Journal Of Science And Research
Bacteriological and Immunological Study of Rheumatoid Arthritis
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The current study included the collection of 175 samples of blood (Urea-blood) of patients with rheumatoid arthritis from Al–Al-Kindy Teaching Hospital, Baghdad Teaching Hospital and Al-Imamian Al-Kadhimyain Medical City in Baghdad from both sexes with different ages at the period between 1/10/2016-1/2/2017. Bacterial growth results showed that 80% of urea for bacterial transplantation were positive results, while the number of samples showing no bacterial growth was 20%. The bacterial isolation evaluate for morphological testes and biochemical microscopy, as well as identification by Api system. The highest frequency of inflectional bacteria was E. coli (41.97%), followed by E. cloacae (21.25%), P. aeruginosa (12.5%), Salmonella (10%), K

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Publication Date
Tue Jun 01 2021
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Estimation of Some Biomarkers and Cholesterol / HDL Ratio to Predict the Risk of Cardiovascular Disease in Rheumatoid Arthritis
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Rheumatoid arthritis (AR) is one of the chronic diseases resulting in many complications such as cardiovascular disease (CVD). Any change in the lipid profiles and myocardial markers indicates cardiovascular disease risk, so this study is designed to monitor the pattern of lipid profiles and myocardial markers in newly diagnosed RA patients. Blood samples were collected from 70 Iraqi patients newly diagnosed with rheumatoid arthritis (male and female) and 30 healthy served as control. These individuals were aged 35-65 years. The serum samples were obtained to determine myocardial markers; included troponin, creatinine kinase (CK), lactate dehydrogenase (LDH), and glutamic oxaloacetic transaminase GOT; and lipid profiles; such as choleste

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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Knowledge and Perception of Iraqi Pharmacists Towards Biosimilar Medicines
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Abstract

Biosimilars are non-innovative copy versions of biologic medicines which are proven to be clinically equivalent to, as effective and as safe as their reference biologics. Biosimilars creates opportunities for cost savings for payers, governments, and patients compared with the reference products. Pharmacist plays an essential role in developing biosimilar medicines from manufacturing to post-marketing pharmacovigilance monitoring. The aim of the current study was to explore  the level of  knowledge, behaviors and practices of  a sample of Iraqi pharmacists towards biosimilar medicines.  The current study was a cross sectional, carried out during May 2020. A total of 2

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