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Lorenzovici L, Szilberhorn L, Farkas-Ráduly S, Gasparik AI, Precup AM, Nagy AG, Niemann CU, Aittokallio T, Kaló Z, Csanádi M. Systematic Literature Review of Economic Evaluations of Treatment Alternatives in Chronic Lymphocytic Leukemia. BioDrugs 2023; 37:219-233. [PMID: 36795353 PMCID: PMC9971131 DOI: 10.1007/s40259-023-00583-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Economic evaluations are widely used to predict the economic impact of new treatment alternatives. Comprehensive economic reviews in the field of chronic lymphocytic leukemia (CLL) are warranted to supplement the existing analyses focused on specific therapeutic areas. METHODS A systematic literature review was conducted based on literature searches in Medline and EMBASE to summarize the published health economics models related to all types of CLL therapies. Narrative synthesis of relevant studies was performed focusing on compared treatments, patient populations, modelling approaches and key findings. RESULTS We included 29 studies, the majority of which were published between 2016 and 2018, when data from large clinical trials in CLL became available. Treatment regimens were compared in 25 cases, while the remaining four studies considered treatment strategies with more complex patient pathways. Based on the review results, Markov modelling with a simple structure of three health states (progression-free, progressed, death) can be considered as the traditional basis to simulate cost effectiveness. However, more recent studies added further complexity, including additional health states for different therapies (e.g. best supportive care or stem cell transplantation), for progression-free state (e.g. by differentiating between with or without treatment), or for response status (i.e. partial response and complete response). CONCLUSIONS As personalized medicine is increasingly gaining recognition, we expect that future economic evaluations will also incorporate new solutions, which are necessary to capture a larger number of genetic and molecular markers and more complex patient pathways with individual patient-level allocation of treatment options and thus economic assessments.
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Affiliation(s)
- László Lorenzovici
- Syreon Research Romania, Targu Mures, Romania.,George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | | | | | - Andrea Ildiko Gasparik
- George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | | | | | - Carsten Utoft Niemann
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Tero Aittokallio
- Institute for Molecular Medicine Finland, Helsinki Institute for Life Sciences, University of Helsinki, Helsinki, Finland.,Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Oslo Centre for Biostatistics and Epidemiology (OCBE), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Zoltán Kaló
- Syreon Research Institute, Budapest, Hungary.,Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
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Mihai G, Gasparik AI, Pascanu IM, Cevei M, Hutanu A, Pop RM. The influence of Visfatin, RBP-4 and insulin resistance on bone mineral density in women with treated primary osteoporosis. Aging Clin Exp Res 2019; 31:889-895. [PMID: 31054116 DOI: 10.1007/s40520-019-01206-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/12/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The impact of the two adipokines, visfatin and retinol-binding protein 4 (RBP-4) on bone mineral density (BMD) has been analysed in various studies with conflicting results. Visfatin is highly expressed in visceral fat with stimulatory effect on osteoblast proliferation and inhibition on osteoclast formation, while RBP-4 acts as a transporter protein for retinol, associated with changes in insulin sensitivity, independent of obesity, with no consensus on its effect on bone metabolism. We evaluated the relationship between serum concentrations of visfatin, RBP-4, markers of insulin resistance and current BMD in treated postmenopausal osteoporosis (PO). METHODS Demographics, previous treatment, metabolic status, anthropometry, serum Alkaline phosphatise (ALP), visfatin, RBP-4, the HOMA IR (homeostatic model assessment of insulin resistance) index and BMD were evaluated in 61 subjects with PO. Statistical analysis used SPSS v. 25.0, with a level of significance α = 0.05. Regression models were constructed to evaluate the relationship between adipokines and BMD, adjusting for covariates. RESULTS In multilinear regression analysis, the strongest predictor for current BMD was a previous BMD, followed by ALP and age. RBP4 and HOMA IR were significant predictors, while visfatin had no significant effect. A significant correlation between body mass index (BMI) and BMD at the femoral neck was observed. ALP was negatively correlated with BMD and visfatin positively with RBP4. CONCLUSIONS Data indicate a positive relationship between BMD and RBP-4, an inverse relationship between markers of insulin resistance, bone turn-over and current BMD. No significant effect of visfatin on BMD was observed.
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Affiliation(s)
- Gabriela Mihai
- Department of Endocrinology, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania
| | - Andrea Ildiko Gasparik
- Department of Public Health and Health Management, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania.
| | - Ionela Maria Pascanu
- Department of Endocrinology, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania
| | - Mariana Cevei
- Medical Rehabilitation Hospital Băile Felix, Comuna Sinmartin, Romania
| | - Adina Hutanu
- Department of Laboratory Medicine, Centre for Advanced Medical and Pharmaceutical Research, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania
| | - Raluca-Monica Pop
- Research Methodology Department, University of Medicine, Pharmacy, Sciences and Technology of Tirgu Mureş, Str. Gh Marinescu nr 38, Tirgu Mureş, Romania
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Gasparik AI, Mihai G, Beaudart C, Bruyere O, Pop RM, Reginster JY, Pascanu IM. Psychometric performance of the Romanian version of the SarQoL®, a health-related quality of life questionnaire for sarcopenia. Arch Osteoporos 2017; 12:103. [PMID: 29139012 DOI: 10.1007/s11657-017-0397-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Our study assessed the psychometric properties of the Romanian SarQoL® questionnaire. Normal distribution and high internal consistency were found. Sarcopenic subjects reported a reduced global quality of life compared to non-sarcopenics. The Romanian version of the SarQoL® questionnaire, conceptually and literally equivalent with the source instrument, is qualified in terms of psychometric properties. PURPOSE/INTRODUCTION We have recently provided a translated and culturally tailored version of the first quality of life (QoL) questionnaire specific for sarcopenia, the SarQoL®, in Romanian language. The aim of this study was to assess the psychometric performances of the translated questionnaire. METHODS A total of 100 volunteers were enrolled in the study. Sarcopenia was diagnosed according to the algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). To test the psychometric performance, discriminative power, internal consistency, floor and ceiling effects, and construct validity analyses were made. We assessed the correlation between SarQoL® and similar/different domains of other two QoL questionnaires. RESULTS Sarcopenic subjects reported a reduced global QoL compared to non-sarcopenic individuals. Significantly (p = 0.018) higher total scores for non-sarcopenic subjects compared to those of sarcopenics indicate a good discriminative power of the Romanian questionnaire. Sarcopenic individuals had significantly lower scores in almost all domains. The Cronbach's alpha value of 0.946 indicates a high internal consistency. No floor or ceiling effects were found. A strong positive correlation was also found between similar domain scores from SF-36 and EQ-5D questionnaires with the Total SarQoL® score. Moreover, lower scores of quality of life have been shown to be significantly associated with lower muscle strength, in univariate analyses, and lower gait speed, both in univariate and multivariate analyses. CONCLUSIONS Our results indicate that the Romanian version of the SarQoL® questionnaire, qualified in terms of psychometric properties, could be a useful tool to assess the sarcopenia-related QoL among frail Romanian individuals.
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Affiliation(s)
- Andrea Ildiko Gasparik
- Public Health and Health Management, Department of University of Medicine and Pharmacy Tîrgu Mures, Gheorghe Marinescu Street No.38, Tîrgu Mures, Mures, Romania
| | - Gabriela Mihai
- Endocrinology Department, University of Medicine and Pharmacy Tîrgu Mures, Gheorghe Marinescu Street No. 38, Tîrgu Mures, Mures, Romania.
| | - Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium
- Quartier Hôpital, University of Liege, Avenue Hippocrate, 13 Bât B23, 4000, Liège, Belgium
| | - Olivier Bruyere
- Department of Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium
- Quartier Hôpital, University of Liege, Avenue Hippocrate, 13 Bât B23, 4000, Liège, Belgium
| | - Raluca-Monica Pop
- Endocrinology Department, University of Medicine and Pharmacy Tîrgu Mures, Gheorghe Marinescu Street No. 38, Tîrgu Mures, Mures, Romania
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium
- Quartier Hôpital, University of Liege, Avenue Hippocrate, 13 Bât B23, 4000, Liège, Belgium
| | - Ionela Maria Pascanu
- Endocrinology Department, University of Medicine and Pharmacy Tîrgu Mures, Gheorghe Marinescu Street No. 38, Tîrgu Mures, Mures, Romania
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Abstract
The importance of healthy behavior for bone health, as well as low adherence to anti-osteoporosis medication are well-described problems. Both, lifestyle habits and compliance with drug-therapy are influenced by the relationship between patients and physicians. We analyzed 152 consecutive doctor-patient interactions conducted in public and private practices specialized in the management of osteoporosis. We recorded the duration of the consultation and the relative length of: (a) Personal and medical history collection, (b) Physical examination, (c) Explanation of the diagnosis and treatment modalities, and (d) Administrative tasks. The overall length and the respective duration of the four phases of the consultation significantly differ in private versus public practices. In the private practice, doctors spend more time with the patient and dedicate a higher proportion of their time to history collection and explanation of diagnosis/treatment for osteoporosis. While we do not integrate data on medication adherence, we believe that since more time is dedicated to health education, patients consulting in the private sector have a greater probability to adopt a healthy lifestyle and better/ longer take anti-osteoporosis medications. Further investigations are needed to assess if the differences in patient and doctor behaviors in the public-private settings have a significant impact on therapeutic adherence and subsequently fracture reduction in patients receiving anti-osteoporosis treatment.
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Affiliation(s)
- Andrea Ildiko Gasparik
- University of Medicine and Pharmacy Tg. Mures, UMF. Tirgu Mures, Str Gh. Marinescu nr. 38, 540139, Târgu Mureş, Romania,
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