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Otiniano A, van de Wyngaert Z, Brissot E, Dulery R, Gozlan J, Daguenel A, Abi Aad Y, Ricard L, Stocker N, Banet A, Bonnin A, Alsuliman T, Marjanovic Z, Schnuriger A, Coppo P, Legrand O, Lacombe K, Mohty M, Malard F. Tixagevimab/cilgavimab for Omicron SARS-CoV-2 infection in patients with haematologic diseases. Bone Marrow Transplant 2023; 58:340-342. [PMID: 36481838 PMCID: PMC9734768 DOI: 10.1038/s41409-022-01894-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Armelle Otiniano
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Zoe van de Wyngaert
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Eolia Brissot
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Rémy Dulery
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Joel Gozlan
- Service de virologie, APHP, Hôpital Saint Antoine, Paris, France
| | - Anne Daguenel
- Pharmacie, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Yasmine Abi Aad
- Sorbonne Université, IPLESP UMR-S1136, Service de maladies infectieuses et tropicales, Hôpital Saint Antoine, AP-HP, Paris, France
| | - Laure Ricard
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Nicolas Stocker
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Anne Banet
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Agnes Bonnin
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Tamim Alsuliman
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Zora Marjanovic
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | | | - Paul Coppo
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Ollivier Legrand
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Karine Lacombe
- Sorbonne Université, IPLESP UMR-S1136, Service de maladies infectieuses et tropicales, Hôpital Saint Antoine, AP-HP, Paris, France
| | - Mohamad Mohty
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Florent Malard
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, INSERM UMRs 938, Paris, France.
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Mosbah H, Vantyghem M, Nobécourt E, Andreelli F, Archambeaud F, Bismuth E, Briet C, Cartigny M, Chevalier B, Donadille B, Daguenel A, Fichet M, Gautier J, Janmaat S, Jéru I, Legagneur C, Leguier L, Maitre J, Mongeois E, Poitou C, Renard E, Reznik Y, Spiteri A, Travert F, Vergès B, Zammouri J, Vigouroux C, Vatier C. Therapeutic indications and metabolic effects of metreleptin in patients with lipodystrophy syndromes: Real-life experience from a national reference network. Diabetes Obes Metab 2022; 24:1565-1577. [PMID: 35445532 PMCID: PMC9541305 DOI: 10.1111/dom.14726] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/05/2022] [Accepted: 04/18/2022] [Indexed: 12/01/2022]
Abstract
AIM To describe baseline characteristics and follow-up data in patients with lipodystrophy syndromes treated with metreleptin in a national reference network, in a real-life setting. PATIENTS AND METHODS Clinical and metabolic data from patients receiving metreleptin in France were retrospectively collected, at baseline, at 1 year and at the latest follow-up during treatment. RESULTS Forty-seven patients with lipodystrophy including generalized lipodystrophy (GLD; n = 28) and partial lipodystrophy (PLD; n = 19) received metreleptin over the last decade. At baseline, the median (interquartile range [IQR]) patient age was 29.3 (16.6-47.6) years, body mass index was 23.8 (21.2-25.7) kg/m2 and serum leptin was 3.2 (1.0-4.9) ng/mL, 94% of patients had diabetes (66% insulin-treated), 53% had hypertension and 87% had dyslipidaemia. Metreleptin therapy, administered for a median (IQR) of 31.7 (14.2-76.0) months, was ongoing in 77% of patients at the latest follow-up. In patients with GLD, glycated haemoglobin (HbA1c) and fasting triglyceride levels significantly decreased from baseline to 1 year of metreleptin treatment, from 8.4 (6.5-9.9)% [68 (48-85) mmol/mol] to 6.8 (5.6-7.4)% [51(38-57) mmol/mol], and 3.6 (1.7-8.5) mmol/L to 2.2 (1.1-3.7) mmol/L, respectively (P < 0.001), with sustained efficacy thereafter. In patients with PLD, HbA1c was not significantly modified (7.7 [7.1-9.1]% [61 (54-76) mmol/mol] at baseline vs. 7.7 [7.4-9.5]% [61(57-80) mmol/mol] at 1 year), and the decrease in fasting triglycerides (from 3.3 [1.9-9.9] mmol/L to 2.5 [1.6-5.3] mmol/L; P < 0.01) was not confirmed at the latest assessment (5.2 [2.2-11.3] mmol/L). However, among PLD patients, at 1 year, 61% were responders regarding glucose homeostasis, with lower baseline leptin levels compared to nonresponders, and 61% were responders regarding triglyceridaemia. Liver enzymes significantly decreased only in the GLD group. CONCLUSIONS In this real-life setting study, metabolic outcomes are improved by metreleptin therapy in patients with GLD. The therapeutic indication for metreleptin needs to be clarified in patients with PLD.
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Affiliation(s)
- Héléna Mosbah
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Marie‐Christine Vantyghem
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital; University of Lille, INSERM U1190European Genomic Institute for DiabetesLilleFrance
| | - Estelle Nobécourt
- Department of Endocrinology, Diabetology and MetabolismLa Réunion University HospitalSaint Pierre de la RéunionFrance
| | - Fabrizio Andreelli
- AP‐HP, Pitié‐Salpêtrière University Hospital, Department of Diabetology; Sorbonne University, INSERMNutrition and Obesity: systemic approaches « NutriOmics »ParisFrance
| | - Francoise Archambeaud
- Department of Endocrinology, Diabetology and MetabolismDupuytren University HospitalLimogesFrance
| | - Elise Bismuth
- AP‐HP, Robert‐Debré University Hospital, Department of Paediatric Endocrinology, Diabetology and MetabolismUniversity of ParisParisFrance
| | - Claire Briet
- Department of EndocrinologyDiabetology and Metabolism, Angers University Hospital, Laboratory MITOVASC, UMR CNRS 6015, INSERM 1083AngersFrance
| | - Maryse Cartigny
- Reference Centre for Rare Diseases of Genital Development DEVGEN, Endocrinology Unit, Diabetology and Paediatric Gynecology DepartmentLille University HospitalLilleFrance
| | - Benjamin Chevalier
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital; University of Lille, INSERM U1190European Genomic Institute for DiabetesLilleFrance
| | - Bruno Donadille
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Anne Daguenel
- Department of PharmacyAP‐HP, Saint–Antoine University HospitalParisFrance
| | - Mathilde Fichet
- Department of Endocrinology, Diabetology and MetabolismRennes University HospitalRennesFrance
| | - Jean‐François Gautier
- Department of Endocrinology, Diabetology and MetabolismAP‐HP, Lariboisière University HospitalParisFrance
| | - Sonja Janmaat
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Isabelle Jéru
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Carole Legagneur
- Department of Paediatric Endocrinology, Diabetology and MetabolismUniversity Hospital Brabois‐Vandoeuvre lès NancyVandoeuvre lès NancyFrance
| | - Lysiane Leguier
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital; University of Lille, INSERM U1190European Genomic Institute for DiabetesLilleFrance
| | - Julie Maitre
- Department of Paediatrics and Endocrinology, Diabetology and MetabolismOrléans HospitalOrléansFrance
| | - Elise Mongeois
- Department of Paediatrics and Endocrinology, Diabetology and MetabolismOrléans HospitalOrléansFrance
| | - Christine Poitou
- Nutrition Department, Sorbonne University/INSERM, Research Unit: Nutrition and Obesity; Systemic Approaches (NutriOmics)AP‐HP, Pitié‐Salpêtrière University Hospital, Reference Centre for Rare Diseases PRADORT (PRADer‐Willi Syndrome and other Rare Obesities with Eating Disorders)ParisFrance
| | - Eric Renard
- Department of Endocrinology, Diabetes and Nutrition, Montpellier University Hospital; Clinical Investigation Centre INSERM1411; Institute of Functional Genomics, CNRS, INSERMUniversity of MontpellierMontpellierFrance
| | - Yves Reznik
- Department of Endocrinology, Diabetology and MetabolismCôte de Nacre University HospitalCaenFrance
| | - Anne Spiteri
- Department of Endocrinology, Diabetology and MetabolismGrenoble University HospitalGrenobleFrance
| | - Florence Travert
- Department of Diabetology and MetabolismAP‐HP, Bichat University HospitalParisFrance
| | - Bruno Vergès
- Department of Endocrinology, Diabetology and MetabolismBocage University HospitalDijonFrance
| | - Jamila Zammouri
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
- AP‐HP, Robert‐Debré University Hospital, Department of Paediatric Endocrinology, Diabetology and MetabolismUniversity of ParisParisFrance
| | - Corinne Vigouroux
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
| | - Camille Vatier
- Endocrinology DepartmentAssistance Publique–Hôpitaux de Paris (AP‐HP), Saint–Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne University, Inserm UMR_S 938, Saint–Antoine Research CentreCardiometabolism and Nutrition University Hospital Institute (ICAN)ParisFrance
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Sokol H, Landman C, Seksik P, Berard L, Montil M, Nion-Larmurier I, Bourrier A, Le Gall G, Lalande V, De Rougemont A, Kirchgesner J, Daguenel A, Cachanado M, Rousseau A, Drouet É, Rosenzwajg M, Hagege H, Dray X, Klatzman D, Marteau P, Beaugerie L, Simon T. Fecal microbiota transplantation to maintain remission in Crohn's disease: a pilot randomized controlled study. Microbiome 2020; 8:12. [PMID: 32014035 PMCID: PMC6998149 DOI: 10.1186/s40168-020-0792-5] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 01/19/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND The role of the gut microbiota in Crohn's disease (CD) is established and fecal microbiota transplantation (FMT) is an attractive therapeutic strategy. No randomized controlled clinical trial results are available. We performed a randomized, single-blind, sham-controlled pilot trial of FMT in adults with colonic or ileo-colonic CD. METHOD Patients enrolled while in flare received oral corticosteroid. Once in clinical remission, patients were randomized to receive either FMT or sham transplantation during a colonoscopy. Corticosteroids were tapered and a second colonoscopy was performed at week 6. The primary endpoint was the implantation of the donor microbiota at week 6 (Sorensen index > 0.6). RESULTS Eight patients received FMT and nine sham transplantation. None of the patients reached the primary endpoint. The steroid-free clinical remission rate at 10 and 24 weeks was 44.4% (4/9) and 33.3% (3/9) in the sham transplantation group and 87.5% (7/8) and 50.0% (4/8; one patient loss of follow-up while in remission at week 12 and considered in flare at week 24) in the FMT group. Crohn's Disease Endoscopic Index of Severity decreased 6 weeks after FMT (p = 0.03) but not after sham transplantation (p = 0.8). Conversely, the CRP level increased 6 weeks after sham transplantation (p = 0.008) but not after FMT (p = 0.5). Absence of donor microbiota engraftment was associated with flare. No safety signal was identified. CONCLUSION The primary endpoint was not reached for any patient. In this pilot study, higher colonization by donor microbiota was associated with maintenance of remission. These results must be confirmed in larger studies (NCT02097797). Video abstract.
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Affiliation(s)
- Harry Sokol
- Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint Antoine, Service de Gastroenterologie, Sorbonne Université, Inserm, 75012, Paris, France.
- Department of Gastroenterology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), 184 rue du Faubourg Saint-Antoine, 75571, Paris, CEDEX 12, France.
- INRA, UMR1319 Micalis & AgroParisTech, Jouy en Josas, France.
- French Group of Fecal Transplantation (GFTF), Paris, France.
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France.
| | - Cecilia Landman
- Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint Antoine, Service de Gastroenterologie, Sorbonne Université, Inserm, 75012, Paris, France
- Department of Gastroenterology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), 184 rue du Faubourg Saint-Antoine, 75571, Paris, CEDEX 12, France
- French Group of Fecal Transplantation (GFTF), Paris, France
| | - Philippe Seksik
- Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint Antoine, Service de Gastroenterologie, Sorbonne Université, Inserm, 75012, Paris, France
- Department of Gastroenterology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), 184 rue du Faubourg Saint-Antoine, 75571, Paris, CEDEX 12, France
- French Group of Fecal Transplantation (GFTF), Paris, France
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
| | - Laurence Berard
- Clinical Research Platform (URC-CRC-CRB), AP-HP Saint-Antoine Hospital, Paris, France
| | - Mélissa Montil
- Clinical Research Platform (URC-CRC-CRB), AP-HP Saint-Antoine Hospital, Paris, France
| | - Isabelle Nion-Larmurier
- Department of Gastroenterology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), 184 rue du Faubourg Saint-Antoine, 75571, Paris, CEDEX 12, France
| | - Anne Bourrier
- Department of Gastroenterology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), 184 rue du Faubourg Saint-Antoine, 75571, Paris, CEDEX 12, France
| | - Guillaume Le Gall
- Department of Gastroenterology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), 184 rue du Faubourg Saint-Antoine, 75571, Paris, CEDEX 12, France
| | - Valérie Lalande
- Department of Microbiology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), Paris, France
| | - Alexis De Rougemont
- National reference center for enteric virus, Virology laboratory, CHU de Dijon, France; UFR des Sciences de Santé, Université de Bourgogne, Dijon, France
| | - Julien Kirchgesner
- Department of Gastroenterology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), 184 rue du Faubourg Saint-Antoine, 75571, Paris, CEDEX 12, France
| | - Anne Daguenel
- Department of Pharmacy, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), Paris, France
| | - Marine Cachanado
- Clinical Research Platform (URC-CRC-CRB), AP-HP Saint-Antoine Hospital, Paris, France
| | - Alexandra Rousseau
- Clinical Research Platform (URC-CRC-CRB), AP-HP Saint-Antoine Hospital, Paris, France
| | - Élodie Drouet
- Clinical Research Platform (URC-CRC-CRB), AP-HP Saint-Antoine Hospital, Paris, France
| | - Michelle Rosenzwajg
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
- Immunology-Immunopathology-Immunotherapy (I3), Sorbonne University-UPMC Univ Paris 06, INSERM UMR S959, 75005, Paris, France
- Biotherapy (CIC-BTi), Pitié- Salpêtrière Hospital, AP-HP, 75013, Paris, France
| | - Hervé Hagege
- Department of Gastroenterology, CHI Créteil, Créteil, France
| | - Xavier Dray
- Department of Hepato-Gastroenterology, APHP, Saint Antoine Hospital, Sorbonne University, Paris, France
| | - David Klatzman
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
- Immunology-Immunopathology-Immunotherapy (I3), Sorbonne University-UPMC Univ Paris 06, INSERM UMR S959, 75005, Paris, France
- Biotherapy (CIC-BTi), Pitié- Salpêtrière Hospital, AP-HP, 75013, Paris, France
| | - Philippe Marteau
- Department of Hepato-Gastroenterology, APHP, Saint Antoine Hospital, Sorbonne University, Paris, France
| | - Laurent Beaugerie
- Department of Gastroenterology, Saint Antoine Hospital, Assitance Publique-Hopitaux de Paris (APHP), 184 rue du Faubourg Saint-Antoine, 75571, Paris, CEDEX 12, France
- Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France
| | - Tabassome Simon
- Clinical Research Platform (URC-CRC-CRB), AP-HP Saint-Antoine Hospital, Paris, France
- Department of Clinical Pharmacology, APHP, Saint Antoine Hospital, Paris, France
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Vatier C, Arnaud L, Prieur X, Guyomarch B, Le May C, Bigot E, Pichelin M, Daguenel A, Vantyghem MC, Gautier JF, Vigouroux C, Cariou B. One-year metreleptin therapy decreases PCSK9 serum levels in diabetic patients with monogenic lipodystrophy syndromes. Diabetes & Metabolism 2017; 43:275-279. [DOI: 10.1016/j.diabet.2016.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/25/2016] [Accepted: 08/29/2016] [Indexed: 12/23/2022]
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Morand-Joubert L, Meynard J, Daguenel A, Charrois A, Girard P, Lacombe K. L-04 Diminution de la prévalence des mutations de résistance au VIH-1 chez les patients en échec virologique, entre 2000 et 2006. Med Mal Infect 2008. [DOI: 10.1016/s0399-077x(08)73167-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Borget I, Tilleul P, Baud M, Joly AC, Daguenel A, Chouaid C. Routine once-weekly darbepoetin alfa administration is cost-effective in lung cancer patients with chemotherapy-induced anemia: A Markov analysis. Lung Cancer 2006; 51:369-76. [PMID: 16388876 DOI: 10.1016/j.lungcan.2005.10.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2005] [Revised: 10/25/2005] [Accepted: 10/31/2005] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite the clinical efficacy of recombinant human erythropoietin (RHE) on chemotherapy-induced anemia, most cost-effectiveness studies have given unfavorable results. OBJECTIVE To determine the cost of managing anemia in unselected patients receiving chemotherapy for lung cancer, and the efficacy and cost-effectiveness of RHE. METHOD We constructed Markov models of two cohorts of patients who received (n=94) or did not receive (n=89) darbepoetin (one weekly injection when the hemoglobin level fell below 11 g/dl), focusing on changes in hemoglobin levels, transfusion requirements, anemia management costs, and the cost-effectiveness ratios of the two management strategies. RESULTS The use of RHE significantly reduced the proportion of patients needing transfusions (from 33.6% to 19.1%, p<0.05) and the number of red cell units used by transfusion (from 2.97+/-1.47 to 2.11+/-0.47, p<0.01). Markov modeling showed that the RHE strategy significantly increased the mean Hb level (13+/-0.5 g/dl versus 11.9+/-1g/dl, p<0.001), at the price of an increase in the main cost (respectively, US$ 1732+/-897 and 996+/-643; p<0.01). The cost-effectiveness ratio favored the RHE strategy (7.02 versus 9.04). Sensitivity analysis showed that the RHE strategy remained dominant in most situations. CONCLUSION Routine use of RHE appears to be cost-effective in patients receiving chemotherapy for lung cancer.
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Affiliation(s)
- Isabelle Borget
- Department of Pharmacy, Hôpital Saint Antoine, AP-HP, 75012 Paris, France
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Laporte JP, Lesage S, Woler M, Parlier Y, Daguenel A, Najman A, Gorin NC. Administration of three cytokines instead of bone marrow transplantation in an HIV+ patient with high-grade lymphoma. Eur J Haematol 1994; 53:123-5. [PMID: 7522189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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