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001-es BibID:	BIBFORM119143
035-os BibID:	(scopus)85181176590 (wos)001130397900001
Első szerző:	Spelman, Tim
Cím:	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom / Spelman T., Herring W. L., Acosta C., Hyde R., Jokubaitis V. G., Pucci E., Lugaresi A., Laureys G., Havrdova E. K., Horakova D., Izquierdo G., Eichau S., Ozakbas S., Alroughani R., Kalincik T., Duquette P., Girard M., Petersen T., Patti F., Csepany T., Granella F., Grand'Maison F., Ferraro D., Karabudak R., Jose Sa M., Trojano M., van Pesch V., Van Wijmeersch B., Cartechini E., McCombe P., Gerlach O., Spitaleri D., Rozsa C., Hodgkinson S., Bergamaschi R., Gouider R., Soysal A., Prevost J., Garber J., de Gans K., Ampapa R., Simo M., Sanchez-Menoyo J. L., Iuliano G., Sas A., van der Walt A., John N., Gray O., Hughes S., De Luca G., Onofrj M., Buzzard K., Skibina O., Terzi M., Slee M., Solaro C., Ramo-Tello C., Fragoso Y., Shaygannejad V., Moore F., Rajda C., Aguera-Morales E., Butzkueven H.
Dátum:	2024
ISSN:	1369-6998 1941-837X
Megjegyzések:	Aim To evaluate the real-world comparative effectiveness and the cost-effectiveness, from a UK National Health Service perspective, of natalizumab versus fingolimod in patients with rapidly evolving severe relapsing-remitting multiple sclerosis (RES-RRMS). Methods Real-world data from the MSBase Registry were obtained for patients with RES-RRMS who were previously either naive to disease-modifying therapies or had been treated with interferon-based therapies, glatiramer acetate, dimethyl fumarate, or teriflunomide (collectively known as BRACETD). Matched cohorts were selected by 3-way multinomial propensity score matching, and the annualized relapse rate (ARR) and 6-month?confirmed disability worsening (CDW6M) and improvement (CDI6M) were compared between treatment groups. Comparative effectiveness results were used in a cost-effectiveness model comparing natalizumab and fingolimod, using an established Markov structure over a lifetime horizon with health states based on the Expanded Disability Status Scale. Additional model data sources included the UK MS Survey 2015, published literature, and publicly available sources. Results In the comparative effectiveness analysis, we found a significantly lower ARR for patients starting natalizumab compared with fingolimod (rate ratio [RR]?=?0.65; 95% confidence interval [CI], 0.57?0.73) or BRACETD (RR = 0.46; 95% CI, 0.42?0.53). Similarly, CDI6M was higher for patients starting natalizumab compared with fingolimod (hazard ratio [HR]?=?1.25; 95% CI, 1.01?1.55) and BRACETD (HR = 1.46; 95% CI, 1.16?1.85). In patients starting fingolimod, we found a lower ARR (RR = 0.72; 95% CI, 0.65?0.80) compared with starting BRACETD, but no difference in CDI6M (HR = 1.17; 95% CI, 0.91?1.50). Differences in CDW6M were not found between the treatment groups. In the base-case cost-effectiveness analysis, natalizumab dominated fingolimod (0.302 higher quality-adjusted life-years [QALYs] and ?17,141 lower predicted lifetime costs). Similar cost-effectiveness results were observed across sensitivity analyses. Conclusions This MSBase Registry analysis suggests that natalizumab improves clinical outcomes when compared with fingolimod, which translates to higher QALYs and lower costs in UK patients with RES-RRMS.
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Multiple sclerosis natalizumab fingolimod real-world data comparative effectiveness cost-effectiveness
Megjelenés:	Journal of Medical Economics. - 27 : 1 (2024), p. 109-125. -
További szerzők:	Herring, W. L. Acosta, C. Hyde, R. Jokubaitis, Vilija Pucci, Eugenio Lugaresi, Alessandra Laureys, Guy Havrdova, Eva Horakova, Dana Izquierdo, Guillermo Eichau, Sara Ozakbas, Serkan Alroughani, Raed Kalincik, Tomas Duquette, Pierre Girard, Marc Petersen, Thor Patti, Francesco Csépány Tünde (1956-) (neurológus, pszichiáter) Granella, Franco Grand'Maison, Francois Ferraro, D. Karabudak, Rana José Sá, Maria Trojano, Maria Pesch, Vincent van Wijmeersch, Bart Van Cartechini, Elisabetta McCombe, Pamela Gerlach, Oliver Spitaleri, Daniele Rózsa Csilla Hodgkinson, Suzanne Bergamaschi, Roberto Gouider, Riadh Soysal, Aysun Prevost, Julie Garber, Justin de Gans, Koen Ampapa, Radek Simó Magdolna Sanchez-Menoyo, Jose Iuliano, Gerardo Sas Attila Walt, Anneke van der John, Nevin Gray, Orla Hughes, Stella De Luca, Giacomo Onofrj, Marco Buzzard, Katherine Skibina, Olga Terzi, Murat Slee, Mark Solaro, Claudio Ramo-Tello, Cristina Fragoso, Yara Shaygannejad, Vahid Moore, Fraser Rajda Cecília Aguera-Morales, Eduardo Butzkueven, Helmut
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