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Comparative Life Cycle Assessment of rheumatoid arthritis treatments

Abstract : Rheumatoid arthritis is a chronic inflammatory degenerative disease that affects millions of people worldwide leading to painful side effects and shorter life span. The treatment remains a challenge since the active ingredient is not specific, potentially causing important side effects. A comparative LCA has been performed within the European project NANOFOL, between two existing treatments (based on pills or subcutaneous injections) and two prospective nanovesicle treatments (based on liposome or bovine albumin serum nanovesicles), permitting to reduce by a factor of 5 the amount of active substance (methothrexate, MTX) administred. Specific characterization factors have been calculated to evaluate the potential toxic and ecotoxic impacts of MTX and its metabolite, using the model USEtox. In contrast to most LCA of medications, the End-Of-Life ecotoxicity and human toxicity impacts of MTX excreta released to surface water after WasteWater Treatment (WWT) were also included. The results show the foremost importance of nurse transportation for scenarios needing it, representing more than 95% of the overall impacts, followed by packaging steps. When excluding transportation, new treatment strategies have the same order of magnitude than the subcutaneous injection existing treatment and are more than one order of magnitude more impactful than the oral treatment. The toxic impacts associated with the excreta emissions after WWT have rather low impacts on general population, one to three orders of magnitude lower than the impacts linked to particulate matter for drug production without transportation. The patient side-effects are of the same order of magnitude as the nurse transportation impacts. Thus the MTX dose reduction in the nanodelivery scenarios, leads to an important absolute reduction in impact for the patient himself. Sensitivity study shows that WWT abatement rate and the MTX metabolic rate little influence final results. On the contrary, the MTX dose administered and the distances driven by caregiver play an important role in all impact categories. This study has enabled to identify the main drivers of the impacts and the trade-off between conventional delivery of MTX and nanodelivery. It also permits to highlight the methodological developments regarding the toxic and ecotoxic impacts and to put in perspective the substantial benefits for the patient to receive the treatment versus the limited impacts on the overall population of the MTX excreta.
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Submitted on : Wednesday, April 2, 2014 - 3:59:04 PM
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  • HAL Id : ineris-00971146, version 1
  • INERIS : EN-2013-119



C. Catalan, L. Hamon, Bastien Affeltranger, Anna Kounina, O. Jolliet. Comparative Life Cycle Assessment of rheumatoid arthritis treatments. 23. SETAC Europe annual meeting "Building a better future : Responsible innovation and environmental protection", May 2013, Glasgow, United Kingdom. ⟨ineris-00971146⟩



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