Effectiveness and cost-effectiveness of single bolus treatment with abciximab (Reo Pro) in preventing restenosis following percutaneous transluminal coronary angioplasty in high risk patients
Effectiveness and cost-effectiveness of single bolus treatment with abciximab (Reo Pro) in preventing restenosis following percutaneous transluminal coronary angioplasty in high risk patients
复制标题
阿昔单抗 (Reo Pro) 单次推注治疗预防高危患者经皮冠状动脉腔内成形术后再狭窄的有效性和成本效益
作者：
M. Aristides;M. Gliksman;N. Rajan;P. Davey
目的评价阿昔单抗预防经皮冠状动脉腔内成形术(PTCA)术后再狭窄的临床效果和成本-效果。设计数据来自之前的研究，EPIC试验，因为只有这项试验能够提供能够在六个月内构建成本效益分析的事件数据。审查的所有其他研究数据都支持EPIC试验的结果。为了提供关于长期健康结果的指示性结果，在马尔可夫模型过程中使用美国流行病学数据外推了存活率和无事件存活率。环境及PTCA术后缺血并发症高危患者，按标准处理。干预在静脉注射肝素和阿司匹林方案中加入阿昔单抗。结果EPIC研究(n=2099)显示严重心血管事件的绝对减少8.1%(95%可信区间3.1%至12.7%)，相对风险降低23%(p=0.001)。根据6个月的试验期，每名未发生严重事件的患者的额外成本(澳元)为13 012美元，对于结果的特殊风险/收益衡量标准，额外成本为14 243美元。流行病学数据支持临床成功的PTCA延长生存期和无缺血事件生存期。模型分析的结果表明，每增加一个寿命年的成本为5547美元，每增加一个非事件年的成本为4285美元。结论阿昔单抗在6个月内可改善临床上重要的预后。一项模型练习探索并强调了显著的长期健康益处的可能性。该分析为决策者和资助者提供信息，以考虑阿昔单抗的性价比。
Objective To assess the clinical effectiveness and cost effectiveness of abciximab in preventing restenosis after percutaneous transluminal coronary angioplasty (PTCA). Design Data from a previous study, the EPIC trial, were used because only this trial was able to provide event data capable of constructing a cost effectiveness analysis over six months. All other study data reviewed supported the findings of the EPIC trial. To provide indicative results on long term health outcomes, survival and event-free survival were extrapolated using US epidemiological data in a Markov modelling process. Setting and patients Patients who were at high risk for ischaemic complications after PTCA, treated in the standard manner. Interventions Abciximab was added to the regimen of intravenous heparin and aspirin. Results The EPIC study (n = 2099) indicated an 8.1% absolute reduction in serious cardiovascular events (95% confidence interval 3.1% to 12.7%) and a 23% relative risk reduction (p = 0.001). Based on the six month trial period, the additional cost per patient free from a serious event (Australian dollars) is $13 012 and for a special risk/benefit measure of outcome, the additional cost is $14 243. Epidemiological data support extended survival and ischaemic event-free survival with clinically successful PTCA. The results of the modelled analysis indicate a cost per additional life-year gained of $5547 and a cost per additional year event-free of $4285. Conclusions At up to six months abciximab offers improvements in clinically important outcomes. A modelling exercise explores and highlights the likelihood of significant long term health benefits. The analysis provides information for decision makers and funders to consider the value for money of abciximab.
PTCA 干预的改善是否影响长期预后？
影响因子：
37.8
作者：
Detre,K;Yeh,W;Kelsey,S;Williams,D;Desvigne-Nickens,P;HolmesJr,D;Bourassa,M;King3rd,S;Faxon,D;Kent,K
通讯作者：
Kent,K
急性心肌梗死紧急冠状动脉成形术后第一年的生存率和心脏事件率。
影响因子：
24
作者：
Stack,RS;Califf,RM;Hinohara,T;Phillips,HR;Pryor,DB;Simonton,CA;Carlson,EB;Morris,KG;Behar,VS;Kong,Y
通讯作者：
Kong,Y