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Álvarez Aldean J, Rivero Calle I, Rodríguez Fernández R, Aceituno Mata S, Bellmunt A, Prades M, Law AW, López-Ibáñez de Aldecoa A, Méndez C, García Somoza ML, Soto J, Lozano V. Cost-effectiveness Analysis of Maternal Immunization with RSVpreF Vaccine for the Prevention of Respiratory Syncytial Virus Among Infants in Spain. Infect Dis Ther 2024:10.1007/s40121-024-00975-6. [PMID: 38733493 DOI: 10.1007/s40121-024-00975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/08/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections (ALRI) in children under one year of age. In high-income countries, RSV infections cause a significant overload of care every winter, imposing a significant burden to the healthcare system, which has made the development of prevention strategies a major global health priority. In this context, a new bivalent RSV prefusion F protein-based vaccine (RSVpreF) has recently been approved. The objective of this study was to evaluate the cost-effectiveness of vaccinating pregnant women with the RSVpreF vaccine to prevent RSV in infants from the Spanish National Healthcare System (NHS) perspective. METHODS A hypothetical cohort framework and a Markov-type process were used to estimate clinical outcomes, costs, quality-adjusted life years (QALY) and cost-per-QALY gained (willingness-to-pay threshold: €25,000/QALY) for newborn infants born to RSV-vaccinated versus unvaccinated mothers over an RSV season. The base case analysis was performed from the NHS perspective including direct costs (€2023) and applying a discount of 3% to future costs and outcomes. To evaluate the robustness of the model, several scenarios, and deterministic and probabilistic analyses were carried out. All the parameters and assumptions were validated by a panel of experts. RESULTS The results of the study showed that year-round maternal vaccination program with 70% coverage is a dominant option compared to no intervention, resulting in direct cost savings of €1.8 million each year, with an increase of 551 QALYs. Maternal vaccination could prevent 38% of hospital admissions, 23% of emergency room visits, 19% of primary care visits, and 34% of deaths due to RSV. All scenario analyses showed consistent results, and according to the probabilistic sensitivity analysis (PSA), the probability of maternal vaccination being cost-effective versus no intervention was 99%. CONCLUSIONS From the Spanish NHS perspective, maternal vaccination with bivalent RSVpreF is a dominant alternative compared with a non-prevention strategy.
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Affiliation(s)
| | - Irene Rivero Calle
- Hospital Clínico Universitario de Santiago de Compostela, A Coruña, Spain
| | | | | | - Alba Bellmunt
- Market Access, Outcomes'10 S.L., Castellón de La Plana, Castellón, Spain.
| | - Miriam Prades
- Market Access, Outcomes'10 S.L., Castellón de La Plana, Castellón, Spain
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Achakkagari SR, Bozan I, Camargo-Tavares JC, McCoy HJ, Portal L, Soto J, Bizimungu B, Anglin NL, Manrique-Carpintero N, Lindqvist-Kreuze H, Tai HH, Strömvik MV. The phased Solanum okadae genome and Petota pangenome analysis of 23 other potato wild relatives and hybrids. Sci Data 2024; 11:454. [PMID: 38704417 PMCID: PMC11069515 DOI: 10.1038/s41597-024-03300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
Potato is an important crop in the genus Solanum section Petota. Potatoes are susceptible to multiple abiotic and biotic stresses and have undergone constant improvement through breeding programs worldwide. Introgression of wild relatives from section Petota with potato is used as a strategy to enhance the diversity of potato germplasm. The current dataset contributes a phased genome assembly for diploid S. okadae, and short read sequences and de novo assemblies for the genomes of 16 additional wild diploid species in section Petota that were noted for stress resistance and were of interest to potato breeders. Genome sequence data for three additional genomes representing polyploid hybrids with cultivated potato, and an additional genome from non-tuberizing S. etuberosum, which is outside of section Petota, were also included. High quality short reads assemblies were achieved with genome sizes ranging from 575 to 795 Mbp and annotations were performed utilizing transcriptome sequence data. Genomes were compared for presence/absence of genes and phylogenetic analyses were carried out using plastome and nuclear sequences.
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Affiliation(s)
- S R Achakkagari
- Department of Plant Science, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - I Bozan
- Department of Plant Science, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - J C Camargo-Tavares
- Department of Plant Science, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - H J McCoy
- Department of Chemistry, University of New Brunswick, Fredericton, NB, Canada
| | - L Portal
- International Potato Center (CIP), Lima, Peru
| | - J Soto
- International Potato Center (CIP), Lima, Peru
| | - B Bizimungu
- Agriculture and Agri-Food Canada Fredericton Research and Development Centre, Fredericton, NB, Canada
| | - N L Anglin
- International Potato Center (CIP), Lima, Peru
- USDA ARS Small Grains and Potato Germplasm Research, Aberdeen, ID, USA
| | - N Manrique-Carpintero
- International Potato Center (CIP), Lima, Peru
- Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Cali, Colombia
| | | | - H H Tai
- Agriculture and Agri-Food Canada Fredericton Research and Development Centre, Fredericton, NB, Canada
| | - M V Strömvik
- Department of Plant Science, McGill University, Sainte-Anne-de-Bellevue, QC, Canada.
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Gonzalez A, Soto J, Babiker N, Wroblewski K, Sawicki S, Schoeller D, Luke A, Huisingh-Scheetz M. Higher baseline resting metabolic rate is associated with 1-year frailty decline among older adults residing in an urban area. BMC Geriatr 2023; 23:815. [PMID: 38062368 PMCID: PMC10704798 DOI: 10.1186/s12877-023-04534-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Dysregulated energy metabolism is one hypothesized mechanism underlying frailty. Resting energy expenditure, as reflected by resting metabolic rate (RMR), makes up the largest component of total energy expenditure. Prior work relating RMR to frailty has largely been done in cross section with mixed results. We investigated whether and how RMR related to 1-year frailty change while adjusting for body composition. METHODS N = 116 urban, predominantly African-American older adults were recruited between 2011 and 2019. One-year frailty phenotype (0-5) was regressed on baseline RMR, frailty phenotype, demographics and body composition (DEXA) in an ordinal logistic regression model. Multimorbidity (Charlson comorbidity scale, polypharmacy) and cognitive function (Montreal Cognitive Assessment) were separately added to the model to assess for change to the RMR-frailty relationship. The model was then stratified by baseline frailty status (non-frail, pre-frail) to explore differential RMR effects across frailty. RESULTS Higher baseline RMR was associated with worse 1-year frailty (odds ratio = 1.006 for each kcal/day, p = 0.001) independent of baseline frailty, demographics, and body composition. Lower fat-free mass (odds ratio = 0.88 per kg mass, p = 0.008) was independently associated with worse 1-year frailty scores. Neither multimorbidity nor cognitive function altered these relationships. The associations between worse 1-year frailty and higher baseline RMR (odds ratio = 1.009, p < 0.001) and lower baseline fat-free mass (odds ratio = 0.81, p = 0.006) were strongest among those who were pre-frail at baseline. DISCUSSION We are among the first to relate RMR to 1-year change in frailty scores. Those with higher baseline RMR and lower fat-free mass had worse 1-year frailty scores, but these relationships were strongest among adults who were pre-frail at baseline. These relationships were not explained by chronic disease or impaired cognition. These results provide new evidence suggesting higher resting energy expenditure is associated with accelerate frailty decline.
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Affiliation(s)
| | - J Soto
- Illinois Institute of Technology, Chicago, USA
| | | | - K Wroblewski
- Department of Public Health Sciences, University of Chicago, Chicago, USA
| | - S Sawicki
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, USA
| | - D Schoeller
- University of Wisconsin in Madison, Madison, USA
| | - A Luke
- Department of Public Health Sciences, Loyola University, Chicago, USA
| | - Megan Huisingh-Scheetz
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, USA.
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Presa M, Vicente D, Calles A, Salinas-Ortega L, Naik J, García LF, Soto J. Cost-Effectiveness of Lorlatinib for the Treatment of Adult Patients with Anaplastic Lymphoma Kinase Positive Advanced Non-Small Cell Lung Cancer in Spain. Clinicoecon Outcomes Res 2023; 15:659-671. [PMID: 37701861 PMCID: PMC10494862 DOI: 10.2147/ceor.s415711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
Purpose The objective of the present study was to evaluate the efficiency of lorlatinib compared to alectinib and brigatinib for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) previously not treated, in Spain. Methods A partitioned survival model comprised progression free, non-intracranial progression, intracranial progression, and death health states was constructed to estimate the total costs, life-years gained (LYG) and quality-adjusted life years (QALYs) accumulated in a lifetime horizon. Overall survival (OS) and progression-free survival (PFS) for lorlatinib were obtained from the CROWN study. For alectinib and brigatinib, a network meta-analysis of randomized controlled trials was conducted to estimate OS and PFS hazard ratios versus crizotinib. Utilities were estimated based on EQ-5D-5L data derived from the CROWN (lorlatinib), ALEX (alectinib) and ALTA-1L (brigatinib) studies. According to the Spanish National Health Service perspective the total costs (expressed in euros using a 2021 cost year) included drug acquisition and the administration's subsequent treatment, ALK+ advanced NSCLC management and adverse-event management, and palliative care. Unitary costs were obtained from local cost databases and literature. Costs, LYGs and QALYs were discounted at 3% annually. Deterministic and probabilistic sensitivity analyses were used to test the model's robustness. Results Lorlatinib provided higher health outcomes (+0.70 LYG/patient, +1.42 QALYs/patient) and lower costs (-€9239/patient) than alectinib. Lorlatinib yielded higher LYG (+1.74) and QALYs (+2.30) versus brigatinib but higher costs/patient (+€36,627), resulting in an incremental-cost-effectiveness-ratio of €15,912/QALY gained. Conclusion The results of this study suggest that lorlatinib may be a dominant treatment option versus alectinib. Considering a willingness-to-pay threshold of €25,000/QALY, lorlatinib may be an efficient option compared to brigatinib.
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Affiliation(s)
- María Presa
- Health Economics, Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain
| | - David Vicente
- Medical Oncology Department, Hospital Universitario Virgen de Macarena, Sevilla, Spain
| | - Antonio Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Laura Salinas-Ortega
- Health Economics, Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain
| | - Jaesh Naik
- Health Economics, BresMed Health Solutions, Sheffield, UK
| | | | - Javier Soto
- Health Economics & Outcomes Research, Pfizer, Madrid, Spain
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Soto J, Bringas M, Gutiérrez Alonso N, Muñoz Martín AJ, Calvo Ferrándiz A, Torres Pérez-Solero G, Ortega L, Martín Lozano R, Jiménez Rodríguez R, Gonzalez Caraballo I, López Jiménez C, Gutierrez Ortiz de la Tabla A, Juliao Caamaño DS, Muñoz MAC, de Lucas MB, Gómez MP, Alva Bianchi M, Martínez Delfrade Í, Martin M, Garcia-Alfonso P. Clinical and survival characteristics of patients with BRAF-mutated metastatic colorectal cancer (mCRC) who receive metastases surgery in a Spanish cohort. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.66] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
66 Background: Patients with mCRC harboring BRAF mutation have worse prognosis and poor outcomes. However, those who have resectable metastatic disease and undergo surgery may have better outcomes compared to those who do not. Differences in clinical characteristics are not well known and may be critical to identify patients with better prognosis. Methods: We performed a retrospective analysis of 299 patients with mCRC in a tumor registry from 2015 to 2021. We compared the clinical characteristics and survival trends of both cohorts (BRAF mutated and BRAF wild type). Furthermore, we analyzed clinical and survival features of 23 patients with BRAF mutated mCRC who received metastases resection. Results: We identified 34 patients with BRAF mutation (11.37%). Several characteristics were significantly more frequent in this group: age <65 years (n = 24, OR 1.38, p = 0.03), female sex (n = 24, OR 1.74, p = 0.008), primary tumor in the right colon (n = 15, OR 1.93, p = 0.003), peritoneal carcinomatosis (n = 18, OR 2.29, p = 0.007) and increased CA19.9 levels at diagnosis (n = 18, OR 1.79, p = 0.003). They received more peritoneal surgery (n = 12, OR 4.27, p = 0.000) and less liver metastases resection (n = 7, OR 0.51, p = 0.011). Median PFS in the first line of treatment was shorter in patients with BRAF mutation (9.5 vs 12.6 months; HR 1.69; IC 95%: 1.16 – 2.45; p = 0.006); however, we did not found differences in OS. Within the 23 patients with BRAF mutated mCRC who underwent surgery (67,64%), we found significant differences compared with those without metastases surgery: primary tumor resection (n = 21, OR 2.51, p = 0.0017) and having a single metastatic location (n = 18, OR 2.04, p = 0.01). Other features were more frequent in patients who underwent surgery but did not reach statistical significance: right colon location (63.6% vs 37.5%), metachronic disease (47.8% vs 18.2%), normal CEA (50% vs 25%) and CA19.9 (45% vs 12%) at diagnosis, and receiving 3 or more lines of systemic treatment (57% vs 22%). Median PFS after metastasectomy was 14.9 months, but we found no differences between both groups. Conclusions: In our cohort, BRAF mutated mCRC patients were more frequently younger, women, had right-sided primary tumors, higher rates of peritoneal metastases and abnormal CA19.9 levels at diagnosis, including worse outcomes in terms of PFS. On the other hand, resection of the primary tumor and single metastatic location were associated with higher probability of having metastases surgery, although in this study no subsequent survival benefit was found, probably due to the small number of BRAF mutated patients analyzed.
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Affiliation(s)
- Javier Soto
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | | | | | | | - Gabriela Torres Pérez-Solero
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañón, IiSGM, Universidad Complutense, Madrid, Spain
| | - Laura Ortega
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rocío Martín Lozano
- Servicio Oncología Médica. Hospital General Universitario Gregorio Marañón. IiSGM. Universidad Complutense, Madrid, Spain
| | | | | | | | | | | | - Marc Ariant Cañete Muñoz
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - Mónica Benavente de Lucas
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - María Palma Gómez
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - Manuel Alva Bianchi
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Miguel Martin
- Instituto De Investigacion Sanitaria Gregorio Maranon, Madrid, Spain
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Bringas M, Soto J, Gutiérrez Alonso N, Muñoz Martín AJ, Calvo Ferrándiz A, Torres Pérez-Solero G, Ortega L, Martín Lozano R, Jiménez Rodríguez R, Gonzalez Caraballo I, Gutierrez Ortiz de la Tabla A, López Jiménez C, Juliao Caamaño DS, Gómez MP, de Lucas MB, Muñoz MAC, Alva Bianchi M, Martínez Delfrade Í, Martin M, Garcia-Alfonso P. Clinical characteristics and survival trends of patients with metastatic colorectal cancer (mCRC) and peritoneal carcinomatosis who receive metastases surgery in a Spanish cohort. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.159] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
159 Background: Peritoneal metastases in patients with mCRC are commonly associated with poor outcomes. Some of these patients are candidates to undergo metastases surgery, which may result in better prognosis; however, clinical and molecular characteristics of these patients remain uncertain. Methods: We conducted a retrospective analysis of 166 patients with mCRC and peritoneal metastases in a tumor registry from 2015 to 2021, analyzing the clinical and molecular characteristics, as well as progression-free survival (PFS) and overall survival (OS) of patients who received peritoneal surgery versus those who did not. Results: From the whole population, 65 patients (39%) underwent peritoneal metastases surgery, and several characteristics were more frequent in this subgroup: ECOG 0 (n = 26, OR 2.75, p = 0,0069), age <65 years (n = 43, OR 2.29, p = 0,0162), absence of hepatic metastases (n = 56, OR 3.31, p = 0,0037), single metastatic location (n = 43, OR 3.48, p = 0,0002), normal CEA levels at diagnosis (n = 33, OR 2.02, p = 0,0455) and BRAF mutation (n = 12, OR 3.32, p = 0,0345). Moreover, these patients received more lines of systemic treatment (2.8 vs 2, p = 0,006) and more metastases surgeries (1.7 vs 0.9, p = 0,000). Significant differences in tumor mutational status regardless of BRAF (KRAS, NRAS, MSI, PI3K and HER2), sex and primary tumor location between groups were not found. PFS was longer in patients receiving metastases surgery (median, 13.68 vs 7.76 months; HR for progression 0.64; 95 % confidence interval (CI) 0.46 to 0.89; p = 0,009), as well as overall survival (median NR vs 29.53; HR for death 0.39; 95 % CI, 0.25 to 0.60; p = 0,000). Conclusions: In our cohort, patients with mCRC and peritoneal carcinomatosis who underwent metastases surgery had more frequently less than 65 years, ECOG 0, absence of liver metastases, single metastatic location, normal CEA levels at diagnosis and BRAF mutation. Moreover, this subgroup showed better outcomes with a statistically significant increase in PFS and OS.
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Affiliation(s)
| | - Javier Soto
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | | | | | - Gabriela Torres Pérez-Solero
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañón, IiSGM, Universidad Complutense, Madrid, Spain
| | - Laura Ortega
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rocío Martín Lozano
- Servicio Oncología Médica. Hospital General Universitario Gregorio Marañón. IiSGM. Universidad Complutense, Madrid, Spain
| | | | | | | | | | | | - María Palma Gómez
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - Mónica Benavente de Lucas
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - Marc Ariant Cañete Muñoz
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - Manuel Alva Bianchi
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Miguel Martin
- Instituto De Investigacion Sanitaria Gregorio Maranon, Madrid, Spain
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Plana MN, Arevalo-Rodriguez I, Fernández-García S, Soto J, Fabregate M, Pérez T, Roqué M, Zamora J. Meta-DiSc 2.0: a web application for meta-analysis of diagnostic test accuracy data. BMC Med Res Methodol 2022; 22:306. [PMID: 36443653 PMCID: PMC9707040 DOI: 10.1186/s12874-022-01788-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 11/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Diagnostic evidence of the accuracy of a test for identifying a target condition of interest can be estimated using systematic approaches following standardized methodologies. Statistical methods for the meta-analysis of diagnostic test accuracy (DTA) studies are relatively complex, presenting a challenge for reviewers without extensive statistical expertise. In 2006, we developed Meta-DiSc, a free user-friendly software to perform test accuracy meta-analysis. This statistical program is now widely used for performing DTA meta-analyses. We aimed to build a new version of the Meta-DiSc software to include statistical methods based on hierarchical models and an enhanced web-based interface to improve user experience. RESULTS In this article, we present the updated version, Meta-DiSc 2.0, a web-based application developed using the R Shiny package. This new version implements recommended state-of-the-art statistical models to overcome the limitations of the statistical approaches included in the previous version. Meta-DiSc 2.0 performs statistical analyses of DTA reviews using a bivariate random effects model. The application offers a thorough analysis of heterogeneity, calculating logit variance estimates of sensitivity and specificity, the bivariate I-squared, the area of the 95% prediction ellipse, and the median odds ratios for sensitivity and specificity, and facilitating subgroup and meta-regression analyses. Furthermore, univariate random effects models can be applied to meta-analyses with few studies or with non-convergent bivariate models. The application interface has an intuitive design set out in four main menus: file upload; graphical description (forest and ROC plane plots); meta-analysis (pooling of sensitivity and specificity, estimation of likelihood ratios and diagnostic odds ratio, sROC curve); and summary of findings (impact of test through downstream consequences in a hypothetical population with a given prevalence). All computational algorithms have been validated in several real datasets by comparing results obtained with STATA/SAS and MetaDTA packages. CONCLUSION We have developed and validated an updated version of the Meta-DiSc software that is more accessible and statistically sound. The web application is freely available at www.metadisc.es .
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Affiliation(s)
- Maria N Plana
- Health Technology Assessment Unit, Hospital Universitario Ramón Y Cajal, IRYCIS, Madrid, Spain. .,CIBER of Epidemiology and Public Health, Madrid, Spain.
| | - Ingrid Arevalo-Rodriguez
- CIBER of Epidemiology and Public Health, Madrid, Spain.,Clinical Biostatistics Unit, Hospital Universitario Ramón Y Cajal, IRYCIS, Madrid, Spain
| | | | - Javier Soto
- Radiology Department, Hospital Universitario Ramón Y Cajal, IRYCIS, UPM, Madrid, Spain
| | - Martin Fabregate
- Internal Medicine Department, Hospital Universitario Ramón Y Cajal, IRYCIS, Madrid, Spain
| | - Teresa Pérez
- Department of Statistics and Data Science, Complutense University of Madrid, Madrid, Spain.,Barts Research Centre for Women's Health, WHO Collaborating Centre, Queen Mary University of London, London, UK
| | - Marta Roqué
- CIBER of Epidemiology and Public Health, Madrid, Spain.,Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Javier Zamora
- CIBER of Epidemiology and Public Health, Madrid, Spain.,Clinical Biostatistics Unit, Hospital Universitario Ramón Y Cajal, IRYCIS, Madrid, Spain.,WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Soto J, Chauvet M, Hartner R, Marceau N, Charest H. Les facteurs sociodémographiques et psychosociaux des poux de tête, Québec, Canada. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.038] [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: 10/16/2022] Open
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Hartner R, Soto J, Chauvet M, Marceau N. 327 - Perception des infirmières scolaires dans le contrôle des poux de tête, Québec, Canada. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.127] [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: 10/16/2022] Open
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Soto J, Barakat M, Hartner R, Bédard P, Germain G. 76 - Les méfaits émotionnels des poux de tête chez les jeunes enfants, Québec, Canada. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.193] [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: 11/16/2022] Open
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Rubio AR, Mareque M, Soto J, Casado MÁ, Álvarez R, Andrade J, Esteban C, Chacón JI. Patient-reported experience in lung and breast cancer through a patient journey. Farm Hosp 2022; 46:215-223. [PMID: 36183219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To analyse a patient journey based on the experience reported by breast and lung cancer patients at Spanish hospital. Method: A mixed design was used, with interviews with 16 health professionals and 25 patients (qualitative method) and a Net Promoter Score questionnaire to 127 patients (quantitative method). INCLUSION CRITERIA oncology patients > 18 years treated in hospital between February- May 2019. EXCLUSION CRITERIA paediatric patients, in palliative care or who were hospitalised at the time of the study. RESULTS Six phases were identified from the data obtained in the qualitative method: my life before diagnosis; discovery; initiation; treatment; followup; and my current life. In the my life before diagnosis phase, a functional level of experience was established, as patients' lives met their expectations. In the discovery phase, patients' expectations were observed to be met, although several satellite experiences were found. In the initiation phase, the experience tended to be negative due to long waiting times and emotional and physical stress. The treatment phase was defined as a basic- poor experience, due to waiting times and lack of institutional support. The experience in the follow-up phase was positive in terms of tests and visits, but critical points were observed in waiting times. In the current phase, the effort made by health professionals to ensure the best possible treatment and care was mentioned. In terms of quantitative analysis, a positive score (46%) was obtained for the Net Promoter Score indicator, as 60% of patients were promoters, i.e. they were satisfied with the service offered by the hospital. CONCLUSIONS This study provides insight into the experience of cancer patients in the six main stages of the disease. The most positive phases were "my life before diagnosis" and "follow-up" while the phases with a negative trend were "initiation" and "treatment" due to the waiting times and the emotional burden on the patient.
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Affiliation(s)
- Ana Rosa Rubio
- Pharmacy Department, Complejo Hospitalario de Toledo, Toledo. Spain..
| | - María Mareque
- Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid. Spain..
| | | | | | - Ruth Álvarez
- Department of Medical Oncology, Complejo Hospitalario de Toledo, Toledo. Spain..
| | - Jesús Andrade
- Department of Medical Oncology, Complejo Hospitalario de Toledo, Toledo. Spain..
| | - Carmen Esteban
- Department of Medical Oncology, Complejo Hospitalario de Toledo, Toledo. Spain..
| | - José Ignacio Chacón
- Department of Medical Oncology, Complejo Hospitalario de Toledo, Toledo. Spain..
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Soto J, Gutiérrez Alonso N, Bringas Beranek M, Catoya Villa JL, Gutierrez Ortiz de la Tabla A, López Jiménez C, Alva Bianchi M, Jiménez Rodríguez R, Martín Lozano R, Arregui Valles M, Aparicio Salcedo I, Ortega Morán L, Torres Pérez-Solero G, Muñoz Martín AJ, Calvo Ferrándiz A, Blanco Codesido M, Martínez Delfrade Í, Juliao Caamaño DS, Martin M, Garcia-Alfonso P. Analysis of survival trends, clinical, and molecular characteristics of patients with early-onset colorectal cancer (EOCRC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.4_suppl.059] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
59 Background: Over the last decades the incidence of EOCRC (age 50 or less) has dramatically increased, and so has the scientific interest in this field, given that clinical and molecular characteristics in these patients are not well understood, and may be critical to identify prognostic factors. Methods: We conducted a retrospective analysis of 554 patients with metastatic colorectal cancer (mCRC), analyzing the PFS and OS of 68 (12.25%) patients with EOCRC, as well as their clinical and molecular characteristics. We used a log-rank test to compare PFS and OS, and the estimate of hazard ratio (HR) between the studied groups was calculated by means of Cox proportional hazard model. We also used the exact test of Fisher to identify significant association between categoric variants, while Mann-Whitney test was applied to identify significant differences between numeric values. Results: We performed a survival analysis: those patients with EOCRC had significantly higher median PFS in first line of treatment (16.2 vs. 11.3 months, p = 0.042) and significantly higher median OS (121.5 vs. 58.1 months, p = 0.011). Several characteristics were significantly more frequent in patients with EOCRC (n=68): BMI < 18.5 (n = 16, OR = 1.9, p = 0.046), primary tumor site at transverse colon (n = 9, OR = 2.61, p = 0.03) and ECOG 0 (n = 32, OR = 2.21, p = 0.003). Having peritoneal metastases almost reached statistical signification (n = 17, OR = 1.82, p = 0.055). Some other characteristics were less frequent: BMI 25-30 (n = 13, OR = 0.51, p = 0.046), primary tumor site at sigmoid colon (n = 14, OR = 0.49, p = 0.038) and former-smoker status (n = 7, OR = 0.44, p = 0.048). Moreover, mean values of LDH at diagnosis were significantly higher in EOCRC patients (359 U/L vs. 280 U/L, p = 0.015). EOCRC patients received a significantly higher number of lines of chemotherapy (2.94 vs. 2.38, p = 0.027) and underwent more surgeries (2,42 vs. 1.24, p < 0,001) than patients with > 50 years. Significant differences in tumor mutational status (BRAF, KRAS, NRAS, MSI, PI3K and HER2), sex, primary tumor resection or number of metastatic sites between groups were not found. Conclusions: This retrospective analysis showed that EOCRC patients had significant higher rates of PFS in first-line treatment and OS. Moreover, EOCRC patients had more frequently BMI < 18.5, primary tumor located at transverse colon and ECOG 0.
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Affiliation(s)
- Javier Soto
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Natalia Gutiérrez Alonso
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - Marianela Bringas Beranek
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | | | | | - Manuel Alva Bianchi
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Roberto Jiménez Rodríguez
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - Rocío Martín Lozano
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañón, IiSGM, Universidad Complutense, Madrid, Spain
| | - Marta Arregui Valles
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Inmaculada Aparicio Salcedo
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Laura Ortega Morán
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañon, IiSGM, Universidad Complutense, Madrid, Spain
| | - Gabriela Torres Pérez-Solero
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañón, IiSGM, Universidad Complutense, Madrid, Spain
| | - Andrés J. Muñoz Martín
- Hospital General Universitario Gregorio Marañón, Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Aitana Calvo Ferrándiz
- Servicio Oncología Médica, Hospital General Universitario Gregorio Marañón, IiSGM, Universidad Complutense, Madrid, Spain
| | | | - Íñigo Martínez Delfrade
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Miguel Martin
- Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Universidad Complutense de Madrid, GEICAM Breast Cancer Group, Madrid, Spain
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Muñoz A, Gallardo E, Agnelli G, Crespo C, Forghani M, Arumi D, Fernández de Cabo S, Soto J. Cost-effectiveness of direct oral anticoagulants compared to low-molecular-weight-heparins for treatment of cancer associated venous thromboembolism in Spain. J Med Econ 2022; 25:840-847. [PMID: 35703036 DOI: 10.1080/13696998.2022.2087998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 10/18/2022]
Abstract
AIM Recent studies have compared the efficacy and safety of direct-acting oral anticoagulants (DOAC) and low-molecular-weight heparin (LMWH) for cancer-associated venous thromboembolism (VTE). However, there is no available cost-effectiveness analysis comparing DOAC and LMWH. The study aimed to conduct a cost-effectiveness analysis of DOAC (apixaban, edoxaban, and rivaroxaban) vs. LMWH for the treatment of cancer-associated VTE in Spain from the Spanish healthcare system perspective. METHODS We developed a Markov model with a 12-month time horizon. The states included pulmonary embolism, deep vein thrombosis, major and non-major bleeding, chronic thromboembolic pulmonary hypertension, post-thrombotic syndrome, and death. The use of medical resources and drug costs were obtained from the 2021 Spanish Ministry of Health database, and the main references for obtaining the outcomes were derived from Caravaggio, Hokusai VTE Cancer, ADAM VTE, and SELECT-D trials. We performed a deterministic and probabilistic sensitivity analysis to validate the robustness. The Incremental Cost-Effectiveness Ratio (ICER) scores cost per life-year (€/LY) gained and cost per quality-adjusted life-year (€/QALY) gained. RESULTS The 12-month cost of DOAC was 1,994€ (apixaban 1,944€, edoxaban 1,968€, rivaroxaban 2,122€) and 2,152€ for LMWH. The amount of QALY for DOAC was 0.54 (apixaban 0.55, rivaroxaban 0.53, and edoxaban 0.52) and 0.53 for LMWH. We observed similar results for LYs. ICER scores in terms both of €/LY and €/QALY show that DOAC is dominant over LMWH and apixaban showed the best profile. LIMITATIONS Our research is based on an indirect comparison of a short-term clinical trial. CONCLUSION Our results suggest that DOAC is cost-effective and cost-saving compared to LMWH in treating VTE.
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Affiliation(s)
- Andrés Muñoz
- Medical Oncology Department, Instituto de Investigación Sanitaria Gregorio Marañon, Universidad Complutense, Madrid, Spain
| | - Enrique Gallardo
- Oncology Department, Parc Taulí Hospital Universitari, Institut d'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Giancarlo Agnelli
- Internal Vascular and Emergency Medicine, Stroke Unit, University of Perugia, Perugia, Italy
| | - Carlos Crespo
- Axentiva Solutions, Barcelona, Spain
- Universidad de Barcelona, Barcelona, Spain
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14
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Rivolo S, Di Fusco M, Polanco C, Kang A, Dhanda D, Savone M, Skandamis A, Kongnakorn T, Soto J. Cost-effectiveness analysis of apixaban versus vitamin K antagonists for antithrombotic therapy in patients with atrial fibrillation after acute coronary syndrome or percutaneous coronary intervention in Spain. PLoS One 2021; 16:e0259251. [PMID: 34767564 PMCID: PMC8589164 DOI: 10.1371/journal.pone.0259251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/17/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND/OBJECTIVE AUGUSTUS trial demonstrated that, for patients with atrial fibrillation (AF) having acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI), an antithrombotic regimen with apixaban and P2Y12 resulted in less bleeding, fewer hospitalizations, and similar ischemic events than regimens including a vitamin K antagonist (VKA), aspirin, or both. This study objective was to evaluate long-term health and economic outcomes and the cost-effectiveness of apixaban over VKA, as a treatment option for patients with AF having ACS/PCI. METHODS A lifetime Markov cohort model was developed comparing apixaban versus VKA across multiple treatment strategies (triple [with P2Y12 + aspirin] or dual [with P2Y12] therapy followed by monotherapy [apixaban or VKA]; triple followed by dual and then monotherapy; dual followed by monotherapy). The model adopted the Spanish healthcare perspective, with a 3-month cycle length and costs and health outcomes discounted at 3%. RESULTS Treatment with apixaban resulted in total cost savings of €883 and higher life years (LYs) and quality-adjusted LYs (QALYs) per patient than VKA (net difference, LYs: 0.13; QALYs: 0.11). Bleeding and ischemic events (per 100 patients) were lower with apixaban than VKA (net difference, -13.9 and -1.8, respectively). Incremental net monetary benefit for apixaban was €3,041, using a willingness-to-pay threshold of €20,000 per QALY. In probabilistic sensitivity analysis, apixaban was dominant in the majority of simulations (92.6%), providing additional QALYs at lower costs than VKA. CONCLUSIONS Apixaban was a dominant treatment strategy than VKA from both the Spanish payer's and societal perspectives, regardless of treatment strategy considered.
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Affiliation(s)
| | | | | | - Amiee Kang
- Bristol Myers Squibb, Lawrenceville, New Jersey, United States of America
| | - Devender Dhanda
- Bristol Myers Squibb, Lawrenceville, New Jersey, United States of America
| | - Mirko Savone
- Pfizer Inc, New York, New York, United States of America
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15
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Barrios V, Cinza-Sanjurjo S, Gavín O, Egocheaga I, Burgos-Pol R, Soto J, Polanco C, Suárez J, Casado MÁ. Carga y coste del mal control de la anticoagulación con antagonistas de la vitamina K en pacientes con fibrilación auricular no valvular en España. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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16
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Soto L, Soto J, Riquelme F. Hacia un modelo de atención en salud para el siglo XXI: breve historia del modelo de atención integrada en Chile. Revista Médica Clínica Las Condes 2021. [DOI: 10.1016/j.rmclc.2021.06.001] [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: 10/20/2022] Open
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17
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Wise TL, Tillman PB, Soto J, Touchette KJ, Dozier WA. Determination of the optimum digestible isoleucine to lysine ratios for male Yield Plus × Ross 708 broilers between 1.0 and 4.0 kg body weight utilizing growth performance and carcass characteristics. Poult Sci 2021; 100:101307. [PMID: 34332225 PMCID: PMC8339330 DOI: 10.1016/j.psj.2021.101307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/12/2021] [Accepted: 06/01/2021] [Indexed: 11/28/2022] Open
Abstract
Three experiments (Exp) were conducted to determine optimal digestible Ile to Lys ratios for male Yield Plus × Ross 708 broilers from approximately 1.0 to 4.0 kg BW. Broilers were fed dose-response diets with inclusions of blood cells that were formulated to contain a gradient of digestible Ile to Lys ratios (0.46 to 0.83). Treatments for Exp 1 to 3 were fed from 21 to 35, 28 to 42, and 35 to 49 d of age, respectively, to target market weights from 2.5 to 4.0 kg. Experiments utilized positive control (PC) diets that did not contain blood cells and were formulated to the same Ile ratios as Treatment 5. Birds and feed were weighed by pen on the first and last days of the experimental period to determine growth performance. Selected broilers were processed and deboned to determine carcass characteristics. For all Exp, quadratic effects (P ≤ 0.001) were observed with BW gain, feed conversion ratio (FCR), breast meat weight, and breast meat yield (BMY) as digestible Ile to Lys ratios increased. Contrasts between PC and Treatment 5 for each Exp displayed no effect of blood cell inclusion with the exception of FCR in Exp 1 (P = 0.001) and BMY in Exp 3 (P = 0.017). Optimum digestible Ile to Lys ratios for Exp 1 were determined to range from 0.640 to 0.725 for growth from 1.0 to 2.5 kg BW (P ≤ 0.001) and breast meat characteristics. In Exp 2, optimum ratios ranged from 0.664 to 0.682 for growth and breast meat characteristics from 1.6 to 3.1 kg BW (P ≤ 0.001). For growth and breast meat characteristics of broilers in Exp 3, optimum ratios ranged from 0.625 to 0.730, from 2.6 to 3.9 kg BW (P ≤ 0.001). Based on these findings, optimum digestible Ile to Lys ratios were determined to range from 0.63 to 0.73 for broilers from 1.0 to 4.0 kg BW.
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Affiliation(s)
- T L Wise
- Department of Poultry Science, Auburn University, Auburn, AL 36849
| | - P B Tillman
- Poultry Technical Nutrition Services LLC, Buford, GA
| | - J Soto
- Ajinomoto Animal Nutrition North America Inc., Chicago, IL 60631
| | - K J Touchette
- Ajinomoto Animal Nutrition North America Inc., Chicago, IL 60631
| | - W A Dozier
- Department of Poultry Science, Auburn University, Auburn, AL 36849.
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18
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Muñoz Martín AJ, Gallardo Díaz E, Crespo C, Masana Domenech R, Soto J, Arumi D, Fernandez S. Cost-effectiveness of apixaban versus other direct oral anticoagulants and low-molecular-weight-heparins for cancer associated venous thromboembolism in Spain. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e18845] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18845 Background: Venous thromboembolism (VTE) causes substantial morbidity and mortality in patients with cancer. The guidelines for the treatment of VTE in cancer patients recommend low molecular weight heparins (LMWH) and direct oral anticoagulants (DOAC) for patients where major bleeding is a low risk factor. Several studies show that DOAC represent a convenient and effective treatment option in alternative to LMWH in patients with deep-vein thrombosis or pulmonary embolism. Even though some recent studies have compared the effectiveness of DOAC vs LMWH, there is no available a cost-effectiveness analysis (CEA) comparing the relative effectiveness and cost-effectiveness of apixaban, other DOAC and. LMWH. The study aim was to conduct a CEA of apixaban (API), edoxaban (EDO), rivaroxaban (RIVA) and LMWH for the treatment of cancer associated VTE in Spain. Methods: We developed a Markov model with 12 transition health states. The model has been face-validated by two oncologists from two different Spanish hospitals. The use of resources and costs were obtained from the 2021 Spanish Ministry of Health database, and the main references for obtaining the outcomes were derived from CARAVAGGIO, HOKUSAI-VTE, ADAM VTE and SELECT-D trials. Our model yielded the effectiveness score in terms of cost per life-year (LY) gained and cost per quality-adjusted for life-year (QALY) gained. The time horizon was 12 months. We performed a deterministic and probabilistic sensitivity analysis to validate the robustness. Results: API showed the lowest 12-month cost (1943 €), and the highest amount of life years (0.79) and highest amount of QALY (0.55) gained. RIVA and EDO were less effective in terms of LY (0.76 and 0.74, respectively) and QALY (0.53 and 0.52, respectively) gained than LMWH (LY of 0.76 and QALY of 0.53), and less costly. The Incremental Cost-Effectiveness Ratio (ICER) scores in terms both of €/LY and €/QALY gained show that API is dominant over LMWH, RIVA and EDO. Conclusions: Our results suggest that API is more effective and more cost-effective than LMWH, RIVA or EDO with the 2021 Spanish healthcare costs. For interpretation of the results, reader must consider that the costs of resources analyzed in this paper may vary from country to country, and dabigatran was not included in the analysis since there are not cancer associated VTE clinical trials with dabigatran data to calculate CEA from.[Table: see text]
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Affiliation(s)
- Andres J. Muñoz Martín
- Hospital General Universitario Gregorio Marañón, Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Enrique Gallardo Díaz
- Department of Oncology, Parc Tauli Sabadell Hospital Universitari, Institut d’Investigatió i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
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Mareque M, Montesinos P, Font P, Guinea JM, de la Fuente A, Soto J, Oyagüez I, Brockbank J, Iglesias T, Llinares J, Sierra J. Cost-Effectiveness Analysis of Gemtuzumab Ozogamicin for First-Line Treatment of Patients with Cd-33 Positive Acute Myeloid Leukaemia in Spain. Clinicoecon Outcomes Res 2021; 13:263-277. [PMID: 33911887 PMCID: PMC8075179 DOI: 10.2147/ceor.s302097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/07/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To assess the incremental cost-utility ratio (ICUR) of gemtuzumab ozogamicin (GO) + standard of care (SOC) vs SOC alone for treatment of patients with de novo AML from a Spanish Health Service perspective. Methods A cohort state-transition model, with 12 health-states, was used to estimate the lifetime accumulated cost and benefits in terms of quality-adjusted-life-years (QALYs) in AML patients with favourable, intermediate, and unknown cytogenetic profiles. Patient profile was defined based on the ALFA-0701 trial. Therapeutic regimens were defined by 5 haematologists. SOC was assumed to be idarubicin and cytarabine, the combination most used in Spain. QALYs were estimated by applying utilities for the time spent by the cohort in each health-state and utility decrements associated with adverse events (AE). Total cost (€,2020) included drug-acquisition, hematologic stem-cell transplantation, disease management, AE management and end-of-life costs. Unit costs were derived from local databases. All parameters were validated by haematologist. Costs and outcomes were discounted (3%/year). Results Higher cost/patient (€177,618 vs €151,434) and greater QALYs (5,70 vs 4,62) were obtained with GO+SOC vs SOC. The ICUR was €24,203/QALY gained. Conclusion This simulation suggests that GO + SOC could be a cost-effective option for treatment of patients with de novo AML in first line.
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Affiliation(s)
- Maria Mareque
- Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, Spain
| | | | - Patricia Font
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | - Itziar Oyagüez
- Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, Spain
| | | | | | | | - Jorge Sierra
- Hospital Universitario de La Santa Creu i Sant Pau, Barcelona, Spain
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20
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Barrios V, Cinza-Sanjurjo S, Gavín O, Egocheaga I, Burgos-Pol R, Soto J, Polanco C, Suárez J, Casado MÁ. Cost and burden of poor anticoagulation control with vitamin K antagonists in patients with nonvalvular atrial fibrillation in Spain. ACTA ACUST UNITED AC 2020; 74:773-780. [PMID: 32980294 DOI: 10.1016/j.rec.2020.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 06/05/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND OBJECTIVES The aim of this analysis was to evaluate the burden and cost of complications due to poor anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF) treated with vitamin K antagonists (VKA) in Spain. METHODS An analytical model was used to estimate annual differences in ischemic stroke, major bleeding, deaths, costs, and potential years of life lost between patients with poor anticoagulation control (time in therapeutic range <65%) and adequate control (time in therapeutic range ≥ 65%) with a 1-year time horizon. Information on the target population (patients ≥ 65 years), event rates, and costs were obtained from national sources. Direct costs in euros (2018) were included from the perspective of the national health system (NHS) and direct and indirect costs from the societal perspective. A sensitivity analysis was performed with post-hoc data from the SPORTIF III/V trials. RESULTS We analyzed a hypothetical cohort of 594 855 patients, 48.3% with poor anticoagulation control, with an increase of 2321 ischemic strokes, 2236 major bleeding events and 14 463 deaths, and an annual incremental cost between €29 578 306 from the NHS perspective and €75 737 451 from the societal perspective. The annual impact of mortality was 170 502 potential years of life lost. The results of the sensitivity analysis showed that the annual cost would reach €97 787 873 from the societal perspective. CONCLUSIONS Poor anticoagulation control with AVK has a strong impact on loss of health and on increased spending for the NHS.
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Affiliation(s)
- Vivencio Barrios
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain.
| | - Sergio Cinza-Sanjurjo
- Centro de Salud Porto do Son, Área Sanitaria de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Olga Gavín
- Servicio de Hematología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Ramón Burgos-Pol
- Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, Spain
| | - Javier Soto
- Farmacoeconomía e Investigación de Resultados, Pfizer S.L.U., Madrid, Spain
| | - Carlos Polanco
- Health Economics and Outcomes Research, Bristol-Myers Squibb, Madrid, Spain
| | - Jorge Suárez
- Health Economics and Outcomes Research, Bristol-Myers Squibb, Madrid, Spain
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Calles A, Aparicio MI, Alva M, Bringas M, Gutierrez N, Soto J, Arregui M, Tirado VC, Álvarez EL, Del Monte-Millán M, Massarrah T, Galera M, Álvarez R, Martín M. Outcomes of COVID-19 in Patients With Lung Cancer Treated in a Tertiary Hospital in Madrid. Front Oncol 2020; 10:1777. [PMID: 33042826 PMCID: PMC7525070 DOI: 10.3389/fonc.2020.01777] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/11/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Cancer patients represent a vulnerable population for COVID-19 illness. We aimed to analyze outcomes of lung cancer patients affected by COVID-19 in a tertiary hospital of a high-incidence region during the pandemic. Methods: We annotated 23 lung cancer patients consecutively diagnosed with COVID-19 at our institution (HGUGM; Madrid, Spain) between March 4th, 2020 and May 12th, 2020. Only patients with a confirmatory SARS-CoV-2 RT-PCR were included in the study. Results: All patients had at least 1 COVID-19 related symptom; cough (48%), shortness of breath (48%), fever (39%), and low-grade fever (30%) were the most common. Time from symptoms onset to first positive SARS-CoV-2 PCR was 5.5 days (range 1-17), with 13% of cases needed from a 2nd PCR to confirm diagnosis. There was a high variability on thoracic imaging findings, with multilobar pneumonia as the most commonly found pattern (74%). Main lab test abnormalities were low lymphocytes count (87%), high neutrophil to lymphocyte ratio -NLR- (78%), and elevated inflammatory markers: fibrinogen (91%), c-reactive protein -CRP- (87%), and D-dimer (70%). In our series, hospitalization rate was 74%, 39% of patients developed acute respiratory distress syndrome (ARDS), and the case-fatality rate was 35% (8/23). 87% of patients received anti-viral treatment (87% hydroxychloroquine, 74% lopinavir/ritonavir, 13% azithromycin), 43% corticosteroids, 26% interferon-β, 4% tocilizumab, and 82% of hospitalized patients received anticoagulation. High-oxygen requirements were needed in 39% of patients, but only 1 pt was admitted for invasive MV and was discharged 42 days after admission. Multiple variables related to tumor status, clinical baseline conditions, and inflammation markers were associated with mortality but did not remain statistically significant in a multivariate model. In patients with lung cancer receiving systemic therapy (n = 242) incidence and mortality from COVID-19 were 4.5, and 2.1%, respectively, with no differences found by type of treatment. Conclusions: Lung cancer patients represent a vulnerable population for COVID-19, according to the high rate of hospitalization, onset of ARDS, and high mortality rate. Although larger series are needed, no differences in mortality were found by type of cancer treatment. Measures to minimize the risk of SARS-CoV-2 infection remain key to protect lung cancer patients.
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Affiliation(s)
- Antonio Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Manuel Alva
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marianela Bringas
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Natalia Gutierrez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Soto
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marta Arregui
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Victoria Clara Tirado
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Enrique Luis Álvarez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - María Del Monte-Millán
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CiberOnc, Madrid, Spain
| | - Tatiana Massarrah
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CiberOnc, Madrid, Spain
| | - Mar Galera
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Rosa Álvarez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Miguel Martín
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CiberOnc, Madrid, Spain
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Calles A, Galera M, Aparicio I, Alva M, Bringas M, Gutierrez N, Soto J, Tirado V, Alvarez R. Abstract PO-036: Safety outcomes of resuming anticancer treatment in patients with lung cancer affected by COVID-19 illness. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.covid-19-po-036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We aimed to describe how patients with lung cancer affected by COVID-19 recovered and were subsequently treated.
Methods: From March 4th to May 12th, 2020, we have previously identified 23 COVID-19 lung cancer patients confirmed by SARS-CoV-2 RT-PCR in our institution (HGUGM; Madrid, Spain). After symptom recovery patients were tested weekly with nasopharyngeal swabs for SARS-CoV2. We did not start any anticancer treatment until at least 1 PCR confirmed a negative SARS-CoV-2 result. We reviewed treatment records, hospitalization, and outcomes of patients who recovered from COVID-19.
Results: With a median follow-up of 9.7 weeks after COVID-19 diagnosis (range 3.7-13 weeks), 15 patients are clinically recovered (65%) and 8 patients died (35%) from COVID-19. In COVID-19 survivors, time to SARS-CoV-2 PCR negativization from symptoms onset was 31 days (range 13-54 days). Three patients remain SARS-CoV-2 RT-PCR positive to date. Of the 12 patients who negativized for SARS-CoV-2, 8 pts have started systemic anticancer treatment as follows: immune checkpoint inhibitors (n=3), chemotherapy (n=3), and initiation of definitive thoracic chemoradiation (n=2). All 3 pts on immunotherapy resumed the same treatment that they were receiving before COVID-19 (pembrolizumab, atezolizumab), as 2 out of 3 pts did with chemotherapy (pemetrexed; carboplatin + paclitaxel). With a median time on treatment of 40 days (range 22-48 days), only 1 patient has developed treatment-related adverse events so far (grade 1 thrombocytopenia after cycle 1, and grade 2 neutropenia after cycle 2 of carboplatin plus etoposide in a patient with relapsed SCLC previously treated with chemoradiation). The 4 patients with negative SARS-CoV-2 PCR who did not start any further treatment had either already completed planned treatment just before COVID-19 or were under surveillance without evidence of disease. Readmission was required in 4/15 patients: 1 pt due to tumor progression and pulmonary embolism, 1 pt due to brain edema from known brain metastasis, 1 pt due to Salmonella gastroenteritis, and 1 pt with hematuria due to prostate cancer. Of note, 1 patient who previously tested negative for SARS-CoV-2 -and who already resumed chemotherapy tested positive again upon admission without COVID-19-related symptoms.
Conclusions: Lung cancer patients who survived COVID-19 can be considered for cancer treatment without preliminary early safety concerns. Long-term efficacy and safety evaluation by treatment modality is needed.
Citation Format: Antonio Calles, Mar Galera, Inmaculada Aparicio, Manuel Alva, Marianela Bringas, Natalia Gutierrez, Javier Soto, Victoria Tirado, Rosa Alvarez. Safety outcomes of resuming anticancer treatment in patients with lung cancer affected by COVID-19 illness [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-036.
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Affiliation(s)
- Antonio Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Mar Galera
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Inmaculada Aparicio
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Alva
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marianela Bringas
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Natalia Gutierrez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Soto
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Victoria Tirado
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rosa Alvarez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Calles A, Aparicio I, Alva M, Bringas M, Gutierrez N, Soto J, Galera M, Alvarez R. Abstract PO-031: Outcomes of COVID-19 in patients with lung cancer treated in a tertiary hospital in Madrid. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.covid-19-po-031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Cancer patients represent a vulnerable population for COVID-19 illness. We aimed to analyze outcomes of lung cancer patients affected by COVID-19 in a tertiary hospital of a high-incidence region during the pandemic.
Methods: We retrospectively collected all lung cancer patients diagnosed with COVID-19 at our institution (HGUGM; Madrid, Spain) between February 24th, 2020 to May 12th, 2020. Patients must have a confirmatory SARS-CoV-2 RT-PCR to be included in the study. Clinically suspected cases and cases with close contact to COVID-19 confirmed cases were not included if either not tested or tested negative by RT-PCR.
Results: On March 4th, 2020, we confirmed our first lung cancer patient with COVID-19 in our institution. Since then, 23 lung cancer pts developed COVID-19 confirmed by SARS-CoV-2 PCR. Median age was 69 years-old (range 49-86), predominantly male (78%), with smoking history (former, 52%; current, 35%), and 87% presented comorbidities. Histology was 61% adenocarcinoma, 26% squamous cell carcinoma (SqCC), and 9% small-cell lung cancer (SCLC). Stage IV was the most commonly found (IVa 22%, IVb 39%), followed by stage III (35%) and stage I-II (4%). 70% of pts were receiving active treatment at the time of COVID-19 diagnosis (30-day window for systemic treatment, 15 days for radiation therapy): chemotherapy (n=4), immune checkpoint inhibitors (n=5), targeted therapy (n=1), thoracic chemo-radiation (n=1), and nonradical nonthoracic radiation therapy (n=6). All lung cancer patients had at least 1 COVID-19 related symptom; cough (48%), shortness of breath (48%), fever (39%), and low-grade fever (30%) were the most common COVID-19 symptoms. Time from symptoms onset to first positive SARS-CoV-2 PCR was 5.5 days (range 1-17), with 13% of cases needing a 2nd PCR to confirm diagnosis. High variability on thoracic imaging findings were found (no pneumonia, n=4; unilobar, n=1; multilobar, n=17). 87% of pts received treatment for COVID-19: hydroxychloroquine (n=20), lopinavir/ritonavir (n=17), azithromycin (n=3), interferon (n=3), and tocilizumab (n=1). In our series, hospitalization rate was 74%, and 39% of pts developed ARDS within 6 days after symptoms initiation (range 2-22 days). Only 1 patient was admitted in the ICU for VM and received tocilizumab and was discharged 42 days after admission. Case fatality rate was 35% (8/23), with 3 pts still on 30-day follow-up period. Considering only those patients with lung cancer who were actively receiving systemic therapy during the pandemic in our institution, we estimated a 4.5% incidence and a 2.1% mortality from COVID-19. Analysis of prognostic factors of mortality is under way.
Conclusions: Lung cancer patients represent a vulnerable population for COVID-19, according to the high rate of hospitalization, onset of ARDS, and high mortality rate. Although larger series are needed, no differences in mortality were found by type of cancer treatment. Measures to minimize the risk of SARS-CoV-2 infection remain key to protect lung cancer patients.
Citation Format: Antonio Calles, Inmaculada Aparicio, Manuel Alva, Marianela Bringas, Natalia Gutierrez, Javier Soto, Mar Galera, Rosa Alvarez. Outcomes of COVID-19 in patients with lung cancer treated in a tertiary hospital in Madrid [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-031.
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Affiliation(s)
- Antonio Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Inmaculada Aparicio
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Alva
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marianela Bringas
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Natalia Gutierrez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Soto
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Mar Galera
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rosa Alvarez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Calles A, Alva M, Aparicio I, Soto J, Gutierrez N, Bringas M, Escudero V, Collado R, Galera M, Alvarez R. Abstract PO-021: Impact of COVID-19 in continuity of cancer treatment for lung cancer patients. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.covid-19-po-021] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We aimed to analyze the impact on treatment delivery in patients with lung cancer during the COVID-19 pandemic and to describe the patterns of treatment change.
Methods: We accessed treatment records of all lung cancer patients treated from 02/20 to 06/20 at the oncology day hospital in our institution (HGUGM; Madrid, Spain). We have prospectively identified all COVID-19 lung cancer patients confirmed by SARS-CoV-2 RT-PCR and included all those on active treatment (<30 days from last dose of any systemic therapy).
Results: A total of 242 patients with lung cancer were receiving active treatment as follows: chemotherapy (117 pts, 48%), immunotherapy (56 pts, 23%), targeted therapy (52 pts, 21%), chemo-immunotherapy (13 pts, 5%), radio-immuno-chemotherapy (4 pts, 2%). Intention of treatment was palliative in 84% vs. curative in 16% (28 pts on chemoradiation; 11 pts on adjuvant/neoadjuvant therapy). Median number of treatment lines was 1 (range 1-6). 11 patients had confirmed COVID-19 illness during active cancer treatment, and 5 patients died due to COVID-19. On average, 61 patients with lung cancer were treated per week before the pandemic. After an initial peak during the first week of pandemic, treatment delivery dropped by -62.2% four weeks after the first case confirmed in our institution (chemotherapy, -58.2%; immunotherapy, -72.6%; chemo-immunotherapy, -100.0%; targeted therapy, -59.0%) and came back to normal at week +7. Treatment interruption or dose delay was observed in 125 pts (28% temporal, 24% definitive). Overall, 23 patients refused to continue treatment due to fear or mobility restrictions due to the pandemic. Additionally, we identified doses skipped in 51 pts (21%), increase on dose intervals in 42 pts (17%), and dose reductions in 16 pts (7%). Route of administration remained the same for all pts but 1 (i.v. to oral). Although absolute use of G-CSF fell by -57.9% during the pandemic, tied to less administration of chemotherapy, the relative use of G-CSF increased in patients receiving chemotherapy-based treatments: G-CSF was initiated in 31 pts who were not previously receiving G-CSF, and expanded in days of use in 7 pts already on treatment. Telemedicine was used in 106/242 patients (44%) to minimize physical presence in the hospital. Drug home delivery system was initiated in 22 patients (9% of total), all of them on targeted therapy (representing 42% of all active patients on targeted therapy). Of the 32 patients who were receiving treatment in clinical trials (10 pts immunotherapy; 8 pts targeted therapy; 8 pts chemo-immunotherapy; 2 chemotherapy, 4 radio-chemo-immunotherapy), neither treatment delays nor COVID-19 illness was documented in any patient.
Conclusions: COVID-19 pandemic significantly modified treatment patterns in patients with lung cancer who were receiving active treatment. Measures were taken to reduce the number of visits to outpatient facilities, and treatment home delivery was facilitated when feasible.
Citation Format: Antonio Calles, Manuel Alva, Inmaculada Aparicio, Javier Soto, Natalia Gutierrez, Marianela Bringas, Vicente Escudero, Roberto Collado, Mar Galera, Rosa Alvarez. Impact of COVID-19 in continuity of cancer treatment for lung cancer patients [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-021.
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Affiliation(s)
- Antonio Calles
- 1Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,
| | - Manuel Alva
- 1Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,
| | - Inmaculada Aparicio
- 1Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,
| | - Javier Soto
- 1Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,
| | - Natalia Gutierrez
- 1Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,
| | - Marianela Bringas
- 1Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,
| | - Vicente Escudero
- 2Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Roberto Collado
- 2Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Mar Galera
- 1Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,
| | - Rosa Alvarez
- 1Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,
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Oyagüez I, Suárez C, López-Sendón JL, González-Juanatey JR, de Andrés-Nogales F, Suárez J, Polanco C, Soto J. Cost-Effectiveness Analysis of Apixaban Versus Edoxaban in Patients with Atrial Fibrillation for Stroke Prevention. Pharmacoecon Open 2020; 4:485-497. [PMID: 31673882 PMCID: PMC7426339 DOI: 10.1007/s41669-019-00186-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Our objective was to assess the cost effectiveness of apixaban versus edoxaban in the prevention of stroke and systemic embolism (SE) in patients with atrial fibrillation (AF) in Spain. METHODS We customized a Markov model with ten health states to estimate the lifetime economic and clinical outcomes in 6-week cycles. The efficacy (clinical event rates per 100 patient-years) and safety data were derived from a pairwise indirect treatment comparison. The analysis was conducted from both the national health service (NHS) and societal perspectives, and included pharmaceutical costs (retail price plus value-added tax (VAT) and applicable national deductions) according to daily dosages (apixaban 10 mg (5 mg twice daily (bid)) and edoxaban 60 or 30 mg) and complications and disease-management costs, obtained from national databases. Utilities for quality-adjusted life-year (QALY) calculations reflected EuroQoL 5-Dimension scores in patients with AF. An annual discount rate of 3% was applied for costs (€, year 2019 values) and outcomes. RESULTS In a 1000-patient cohort, apixaban 5 mg bid versus edoxaban 60 mg could avoid five strokes, six major bleedings and 29 clinically relevant non-major bleedings (CRNMBs). Compared with edoxaban 30 mg, apixaban could avoid 21 strokes and two SEs. An increase in bleedings was observed with apixaban (seven haemorrhagic strokes, 48 major bleedings and 17 CRNMBs). Apixaban yielded 0.04 additional QALYs compared with edoxaban 60 mg or 30 mg. Incremental costs/QALY were €9639.33 and €354.22 for apixaban versus edoxaban 60 mg and edoxaban 30 mg, respectively, from the NHS perspective and €7756.62 for apixaban versus edoxaban 60 mg from the societal perspective. Apixaban was dominant versus edoxaban 30 mg from the societal perspective. Sensitivity analyses confirmed the robustness of the model. CONCLUSIONS This study suggests that apixaban 5 mg bid is a cost-effective alternative to edoxaban for stroke prevention in the AF population in Spain.
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Affiliation(s)
- Itziar Oyagüez
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo, 4 letra I., Pozuelo de Alarcón, 28224, Madrid, Spain.
| | - Carmen Suárez
- Internal Medicine Department, Hospital La Princesa, Madrid, Spain
| | | | | | - Fernando de Andrés-Nogales
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo, 4 letra I., Pozuelo de Alarcón, 28224, Madrid, Spain
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Sacristán JA, Abellán-Perpiñán JM, Dilla T, Soto J, Oliva J. Some reflections on the use of inappropriate comparators in CEA. Cost Eff Resour Alloc 2020; 18:29. [PMID: 32874138 PMCID: PMC7457280 DOI: 10.1186/s12962-020-00226-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 08/18/2020] [Indexed: 11/10/2022] Open
Abstract
Although the choice of the comparator is one of the aspects with a highest effect on the results of cost-effectiveness analyses, it is one of the less debated issues in international methodological guidelines. The inclusion of an inappropriate comparator may introduce biases on the outcomes and the recommendations of an economic analysis. Although the rules for cost-effectiveness analyses of sets of mutually exclusive alternatives have been widely described in the literature, in practice, they are hardly ever applied. In addition, there are many cases where the efficiency of the standard of care has never been assessed; or where the standard of care has demonstrated to be cost-effective with respect to a non-efficient option. In all these cases the comparator may lie outside the efficiency frontier, so the result of the CEA may be biased. Through some hypothetical examples, the paper shows how the complementary use of an independent reference may help to identify potential inappropriate comparators and inefficient use of resources.
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Affiliation(s)
- José Antonio Sacristán
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avenida Arzobispo Morcillo s/n. 28029, Madrid, Spain.,Medical Department, Lilly, Madrid, Spain
| | | | - Tatiana Dilla
- Medical Department, Lilly, Madrid, Spain.,Universidad Carlos III, Madrid, Spain
| | | | - Juan Oliva
- Universidad de Castilla La Mancha, Toledo, Spain
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Soto J, Castaneda-Villa N, Gil A, Gonzalez-Velez V. Simulation of the efficiency of inner hair cell secretion in the auditory pathway. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:2332-2335. [PMID: 31946367 DOI: 10.1109/embc.2019.8857293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Sound coding involves several stages of processing along the auditory path. Specifically, the Inner Hair Cells (IHC) act as sensory receptors and transduce acoustic information -frequency, intensity and duration of the stimulus- into neuronal signals. In this work, a stochastic model was implemented to achieve a better understanding of the IHC-auditory nerve synapse, specifically, the process of Ready Releasable Pool (RRP) vesicle exocytosis, a complicated process to study experimentally because current protocols do not provide adequate temporal resolution, in the order of milliseconds. The presented model allows predicting the efficiency of glutamate release towards explaining maturation changes or disease impacts in the auditory pathway.
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Martínez-Ibernón A, Ramón J, Gandía-Romero J, Gasch I, Valcuende M, Alcañiz M, Soto J. Characterization of electrochemical systems using potential step voltammetry. Part II: Modeling of reversible systems. Electrochim Acta 2019. [DOI: 10.1016/j.electacta.2019.135111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ramón J, Martínez-Ibernón A, Gandía-Romero J, Fraile R, Bataller R, Alcañiz M, García-Breijo E, Soto J. Characterization of electrochemical systems using potential step voltammetry. Part I: Modeling by means of equivalent circuits. Electrochim Acta 2019. [DOI: 10.1016/j.electacta.2019.134702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Burgos-Pol R, Barrios V, Cinza-Sanjurjo S, Gavin O, Egocheaga I, Soto J, Polanco C, Suarez J, Casado MA. P3815Cost and burden of poor control of the level of anticoagulation in patients with non-valvular atrial fibrillation treated with vitamin K antagonist in the Spanish National Health Service. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0657] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Poorly controlled non-valvular atrial fibrillation (NVAF) patients treated with vitamin K antagonists (VKA) experience higher rates of clinical events compared to well controlled patients. In Spain a high percentage of NVAF patients present an inadequate control of anticoagulation therapy, whose economic impact has not been reported yet.
Purpose
To estimate the impact on resource consumption, clinical events and mortality of poorly controlled NVAF patients≥65 years treated with VKA in Spain.
Methods
A cost-consequence analytic model was developed to estimate differences on clinical events and cost between poorly controlled (TTR<65%) and well controlled (TTR≥65%) NVAF patients treated with VKA over 1 year. A hypothetical cohort of NVAF patients was estimated by using local epidemiological studies. Anticoagulation control rates, as measured by Rosendaal method, were retrieved from a literature review of Spanish real-world studies.
Clinical event rates (ischemic stroke-IS-, hemorrhagic stroke-HS-, major bleeding-MB-, systemic embolism-SE- and death for any cause) were derived from a post-hoc analysis of SPORTIF III/V trials. A sensitivity analysis (SA) was performed by using event rates from a prospective single-center study carried out in Spain.
Societal and National Health Service (NHS) perspectives were considered. Total annual costs (€ 2018) included clinical event direct, non-direct healthcare cost and indirect-costs. Potential life years lost (PLYL) were calculated to report impact on mortality. An expert panel composed by a cardiologist, a haematologist and general practitioners validated the model inputs.
Results
The target population comprised 594,855 NVAF patients treated with VKA (mean age 73.2 years, 49.4% women, 74.1% CHADS≥2). Poorly controlled anticoagulated patients accounted for 48.3% of the cohort. The inadequate control of anticoagulation was associated with a higher incidence of clinical events compared to well controlled patients within a year (additional 2,143 IS, 390 HS, 201 SE, 6,190 MB and 6,856 deaths). From NHS perspective, the incremental total annual costs associated to poorly controlled patients were €46,685,756.60 (€173.96/patient-year). When considering the societal perspective, the incremental total annual costs of inadequate anticoagulation control reached €97,787,872.59 (€367.51/patient-year). Mortality due to poorly anticoagulation control implied 80,830.65 PLYL (0.136 PLYL/patient-year). The SA confirmed the base case results.
Conclusions
In the Spanish NHS, around 50% of NVAF patients ≥65 years treated with VKA present an inadequate control of the anticoagulation therapy (287,089 patients), which is associated with the increase of clinical events, mortality and costs (up to €100 million). The results of this study highlight a call to action to increase the awareness of the consequences of a poor anticoagulation control and emphasize the need for a better clinical of patients receiving anticoagulation.
Acknowledgement/Funding
BMS and PFIZER contributed to finance the no conditioned to the results of this work.
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Affiliation(s)
- R Burgos-Pol
- Pharmacoeconomics & Outcomes Research IBERIA (PORIB), Madrid, Spain
| | - V Barrios
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | | | - O Gavin
- Clinical University Hospital Lozano Blesa, Zaragoza, Spain
| | | | - J Soto
- Pfizer Spain, MADRID, Spain
| | | | | | - M A Casado
- Pharmacoeconomics & Outcomes Research IBERIA (PORIB), Madrid, Spain
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Pulido A, Soto J. Incremento de aislamientos de Streptococcus agalactiae en cultivos de orina en un hospital materno-infantil de Lima, Perú. An Fac med 2019. [DOI: 10.15381/anales.802.16427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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32
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Martínez-González MA, Buil-Cosiales P, Corella D, Bulló M, Fitó M, Vioque J, Romaguera D, Martínez JA, Wärnberg J, López-Miranda J, Estruch R, Bueno-Cavanillas A, Arós F, Tur JA, Tinahones F, Serra-Majem L, Martín V, Lapetra J, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, Ros E, Fernández-Aranda F, Botella C, Portillo MP, Lamuela-Raventós RM, Marcos A, Sáez G, Gómez-Gracia E, Ruiz-Canela M, Toledo E, Alvarez-Alvarez I, Díez-Espino J, Sorlí JV, Basora J, Castañer O, Schröder H, Navarrete-Muñoz EM, Zulet MA, García-Rios A, Salas-Salvadó J, Corella D, Estruch R, Fitó M, Martínez-González MA, Ros E, Salas-Salvadó J, Babio N, Ros E, Sánchez-Tainta A, Martínez-González MA, Fitó M, Schröder H, Marcos A, Corella D, Wärnberg J, Martínez-González MA, Estruch R, Fernández-Aranda F, Botella C, Salas-Salvadó J, Razquin C, Bes-Rastrollo M, Sanchez Tainta A, Vázquez Z, SanJulian Aranguren B, Goñi E, Goñi L, Barrientos I, Canales M, Sayón-Orea MC, Rico A, Basterra Gortari J, Garcia Arellano A, Lecea-Juarez O, Carlos Cenoz-Osinaga J, Bartolome-Resano J, Sola-Larraza† A, Lozano-Oloriz E, Cano-Valles B, Eguaras S, Güeto V, Pascual Roquet-Jalmar E, Galilea-Zabalza I, Lancova H, Ramallal R, Garcia-Perez ML, Estremera-Urabayen V, Ariz-Arnedo MJ, Hijos-Larraz C, Fernandez Alfaro C, Iñigo-Martinez B, Villanueva Moreno R, Martin-Almendros S, Barandiaran-Bengoetxea L, Fuertes-Goñi C, Lezaun-Indurain A, Guruchaga-Arcelus MJ, Olmedo-Cruz O, Iñigo-Martínez B, Escriche-Erviti L, Ansorena-Ros R, Sanmatin-Zabaleta R, Apalategi-Lasa J, Villanueva-Telleria J, Hernández-Espinosa MM, Arroyo-Bergera I, Herrera-Valdez L, Dorronsoro-Dorronsoro L, González JI, Sorlí JV, Portolés O, Fernández-Carrión R, Ortega-Azorín C, Barragán R, Asensio EM, Coltell O, Sáiz C, Osma R, Férriz E, González-Monje I, Giménez-Fernández F, Quiles L, Carrasco P, San Onofre N, Carratalá-Calvo A, Valero-Barceló C, Antón F, Mir C, Sánchez-Navarro S, Navas J, González-Gallego I, Bort-Llorca L, Pérez-Ollero L, Giner-Valero M, Monfort-Sáez R, Nadal-Sayol J, Pascual-Fuster V, Martínez-Pérez M, Riera C, Belda MV, Medina A, Miralles E, Ramírez-Esplugues MJ, Rojo-Furió M, Mattingley G, Delgado MA, Pages MA, Riofrío Y, Abuomar L, Blasco-Lafarga N, Tosca R, Lizán L, Guillem-Saiz P, Valcarce AM, Medina MD, Monfort R, de Valcárcel S, Tormo N, Felipe-Román O, Lafuente S, Navío EI, Aldana G, Crespo JV, Llosa JL, González-García L, Raga-Marí R, Pedret Llaberia R, Gonzalez R, Sagarra Álamo R, París Palleja F, Balsells J, Roca JM, Basora Gallisa T, Vizcaino J, Llobet Alpizarte P, Anguera Perpiñá C, Llauradó Vernet M, Caballero C, Garcia Barco M, Morán Martínez MD, García Rosselló J, Del Pozo A, Poblet Calaf C, Arcelin Zabal P, Floresví X, Ciutat Benet M, Palau Galindo A, Cabré Vila JJ, Dolz Andrés F, Boj Casajuana J, Ricard M, Saiz F, Isach A, Sanchez Marin Martinez M, Bulló M, Babio N, Becerra-Tomás N, Mestres G, Basora J, Mena-Sánchez G, Barrubés Piñol L, Gil Segura M, Papandreou C, Rosique Esteban N, Chig S, Abellán Cano I, Ruiz García V, Salas-Huetos A, Hernandez P, Canudas S, Camacho-Barcia L, García-Gavilán J, Diaz A, Castañer O, Muñoz MA, Zomeño MD, Hernaéz A, Torres L, Quifer M, Llimona R, Gal LA, Pérez A, Farràs M, Elosua R, Marrugat J, Vila J, Subirana I, Pérez S, Muñoz MA, Goday A, Chillaron Jordan JJ, Flores Lerroux JA, Benaiges Boix D, Farré M, Menoyo E, Muñoz-Aguayo D, Gaixas S, Blanchart G, Sanllorente A, Soria M, Valussi J, Cuenca A, Forcano L, Pastor A, Boronat A, Tello S, Cabañero M, Franco L, Schröder H, De la Torre R, Medrano C, Bayó J, García MT, Robledo V, Babi P, Canals E, Soldevila N, Carrés L, Roca C, Comas MS, Gasulla G, Herraiz X, Martínez A, Vinyoles E, Verdú JM, Masague Aguade M, Baltasar Massip E, Lopez Grau M, Mengual M, Moldon V, Vila Vergaz M, Cabanes Gómez Ciurana R, Gili Riu M, Palomeras Vidal A, Garcia de la Hera M, González Palacios S, Torres Collado L, Valera Gran D, Compañ Gabucio L, Oncina Canovas A, Notario Barandiaran L, Orozco Beltran D, Pertusa Martínez S, Cloquell Rodrigo B, Hernándis Marsán MV, Asensio A, Altozano Rodado MC, Ballester Baixauli JJ, Fernándis Brufal N, Martínez Vergara MC, Román Maciá J, Candela García I, Pedro Cases Pérez E, Tercero Maciá C, Mira Castejón LA, de los Ángeles García García I, Zazo JM, Gisbert Sellés C, Sánchez Botella C, Fiol M, Moñino M, Colom A, Konieczna J, Morey M, Zamanillo R, Galmés AM, Pereira V, Martín MA, Yáñez A, Llobera J, Ripoll J, Prieto R, Grases F, Costa A, Fernández-Palomeque C, Fortuny E, Noris M, Munuera S, Tomás F, Fiol F, Jover A, Janer JM, Vallespir C, Mattei I, Feuerbach N, del Mar Sureda M, Vega S, Quintana L, Fiol A, Amador M, González S, Coll J, Moyá A, Abete I, Cantero I, Cristobo C, Ibero-Baraibar I, Lezáun Burgui MD, Goñi Ruiz N, Bartolomé Resano R, Cano Cáceres E, Elcarte López T, Echarte Osacain E, Pérez Sanz B, Blanco Platero I, Andueza Azcárate SA, Gimeno Aznar A, Ursúa Sesma E, Ojeda Bilbao B, Martinez Jarauta J, Ugalde Sarasa L, Rípodas Echarte B, Güeto Rubio MV, Fernández-Crehuet Navajas J, Gutiérrez Bedmar M, García Rodriguez A, Mariscal Larrubia A, Carnero Varo M, Muñoz Bravo C, Barón-López FJ, Fernández García JC, Pérez-Farinós N, Moreno-Morales N, del C Rodríguez-Martínez M, Pérez-López J, Benavente-Marín JC, Crespo Oliva E, Contreras Fernández E, Carmona González FJ, Carabaño Moral R, Torres Moreno S, Martín Ruíz MV, Alcalá Cornide M, Fuentes Gómez V, Criado García J, Jiménez Morales AI, Delgado Casado N, Ortiz Morales A, Torres Peña JD, Gómez Delgado FJ, Rodríguez Cantalejo F, Caballero Villaraso J, Alcalá JF, Peña Orihuela PJ, Quintana Navarro G, Casas R, Domenech M, Viñas C, Castro-Barquero S, Ruiz-León AM, Sadurní M, Frontana G, Villanueva P, Gual M, Soriano R, Camafort M, Sierra C, Sacanella E, Sala-Vila A, Cots JM, Sarroca I, García M, Bermúdez N, Pérez A, Duaso I, de la Arada A, Hernández R, Simón C, de la Poza MA, Gil I, Vila M, Iglesias C, Assens N, Amatller M, Rams LL, Benet T, Fernández G, Teruel J, Azorin A, Cubells M, López D, Llovet JM, Gómez ML, Climente P, de Paula L, Soto J, Carbonell C, Llor C, Abat X, Cama A, Fortuny M, Domingo C, Liberal AI, Martínez T, Yañez E, Nieto MJ, Pérez A, Lloret E, Carrazoni C, Belles AM, Olmos C, Ramentol M, Capell MJ, Casas R, Giner I, Muñoz A, Martín R, Moron E, Bonillo A, Sánchez G, Calbó C, Pous J, Massip M, García Y, Massagué MC, Ibañez R, Llaona J, Vidal T, Vizcay N, Segura E, Galindo C, Moreno M, Caubet M, Altirriba J, Fluxà G, Toribio P, Torrent E, Anton JJ, Viaplana A, Vieytes G, Duch N, Pereira A, Moreno MA, Pérez A, Sant E, Gené J, Calvillo H, Pont F, Puig M, Casasayas M, Garrich A, Senar E, Martínez A, Boix I, Sequeira E, Aragunde V, Riera S, Salgado M, Fuentes M, Martín E, Ubieto A, Pallarés F, Sala C, Abilla A, Moreno S, Mayor E, Colom T, Gaspar A, Gómez A, Palacios L, Garrigosa R, García Molina L, Riquelme Gallego B, Cano Ibañez N, Maldonado Calvo A, López Maldonado A, Garrido EM, Baena Dominguez A, García Jiménez F, Thomas Carazo E, Jesús Turnes González A, González Jiménez F, Padilla Ruiz F, Machado Santiago J, Martínez Bellón MD, Pueyos Sánchez A, Arribas Mir L, Rodríguez Tapioles R, Dorador Atienza F, Baena Camus L, Osorio Martos C, Rueda Lozano D, López Alcázar M, Ramos Díaz F, Cruz Rosales Sierra M, Alguacil Cubero P, López Rodriguez A, Guerrero García F, Tormo Molina J, Ruiz Rodríguez F, Rekondo J, Salaverria I, Alonso-Gómez A, Belló MC, Loma-Osorio A, Tojal L, Bruyel P, Goicolea L, Sorto C, Casi Casanellas A, Arnal Otero ML, Ortueta Martínez De Arbulo J, Vinagre Morgado J, Romeo Ollora J, Urraca J, Sarriegui Carrera MI, Toribio FJ, Magán E, Rodríguez A, Castro Madrid S, Gómez Merino MT, Rodríguez Jiménez M, Gutiérrez Jodra M, López Alonso B, Iturralde Iriso J, Pascual Romero C, Izquierdo De La Guerra A, Abbate M, Aguilar I, Angullo E, Arenas A, Argelich E, Bibiloni MM, Bisbal Y, Bouzas C, Busquets C, Capó X, Carreres S, De la Peña A, Gallardo L, Gámez JM, García B, García C, Julibert A, Llompart I, Mascaró CM, Mateos D, Montemayor S, Pons A, Ripoll T, Rodríguez T, Salaberry E, Sureda A, Tejada S, Ugarriza L, Valiño L, Bernal López MR, Macías González M, Ruiz Nava J, Fernández García JC, Muñoz Garach A, Vilches Pérez A, González Banderas A, Alcaide Torres J, Vargas Candela A, León Fernández M, Hernández Robles R, Santamaría Fernández S, Marín JM, Valdés Hernández S, Villalobos JC, Ortiz A, Álvarez-Pérez J, Díaz Benítez EM, Díaz-Collado F, Sánchez-Villegas A, Pérez-Cabrera J, Casañas-Quintana LT, García-Guerra RB, Bautista-Castaño I, Ruano-Rodríguez C, Sarmiento de la Fe F, García-Pastor JA, Macías-Gutiérrez B, Falcón-Sanabria I, Simón-García C, Santana-Santana AJ, Álvarez-Álvarez JB, Díaz-González BV, Castillo Anzalas JM, Sosa-Also RE, Medina-Ponce J, Abajo Olea S, Adlbi Sibai A, Aguado Arconada A, Álvarez L, Carriedo Ule E, Escobar Fernández M, Ferradal García JI, Fernández Vázquez JP, García González M, González Donquiles C, González Quintana C, González Rivero F, Lavinia Popescu M, López Gil JI, López de la Iglesia J, Marcos Delgado A, Merino Acevedo C, Reguero Celada S, Rodríguez Bul M, Vilorio-Marqués L, Santos-Lozano JM, Miró-Moriano L, Domínguez-Espinaco C, Vaquero-Díaz S, García-Corte FJ, Santos-Calonge A, Toro-Cortés C, Pelegrina-López N, Urbano-Fernández V, Ortega-Calvo M, Lozano-Rodríguez J, Rivera-Benítez I, Caballero-Valderrama M, Iglesias-Bonilla P, Román-Torres P, Corchado-Albalat Y, Mayoral-Sánchez E, de Cos AI, Gutierrez S, Artola S, Galdon A, Gonzalo I, Más S, Sierra R, Luca B, Prieto L, Galera A, Gimenez-Gracia M, Figueras R, Poch M, Freixedas R, Trias F, Sarasa I, Fanlo M, Lafuente H, Liceran M, Rodriguez-Sanchez A, Pallarols C, Monedero J, Corbella X, Corbella E, Altés A, Vinagre I, Mestres C, Viaplana J, Serra M, Vera J, Freitas T, Ortega E, Pla I, Ordovás JM, Micó V, Berninches L, Concejo MJ, Muñoz J, Adrián M, de la Fuente Y, Albertos C, Villahoz E, Cornejo ML, Gaforio JJ, Moraleda S, Liétor N, Peis JI, Ureña T, Rueda M, Ballesta MI, Moreno Lopera C, Aragoneses Isabel C, Sirur Flores MA, Ceballos de Diego M, Bescos Cáceres T, Peña Cereceda Y, Martínez Abad M, Cabrera Vela R, González Cerrajero M, Rubio Herrera MA, Torrego Ellacuría M, Barabash Bustelo A, Ortiz Ramos M, Garin Barrutia U, Baños R, García-Palacios A, Cerdá Micó C, Estañ Capell N, Iradi A, Fandos Sánchez M. Cohort Profile: Design and methods of the PREDIMED-Plus randomized trial. Int J Epidemiol 2018; 48:387-388o. [PMID: 30476123 DOI: 10.1093/ije/dyy225] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 01/04/2023] Open
Affiliation(s)
- Miguel A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Pilar Buil-Cosiales
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Monica Bulló
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Clinical Epidemiology and Public Health Department, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Jose López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Cardiology, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Francisco Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Las Palmas de Gran Canaria, Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Jose Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Eating Disorders Unit, Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain
| | - Cristina Botella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - María Puy Portillo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy and Lucio Lascaray Research Center, Universidad del País Vasco (UPV/EHU), Vitoria, Spain
| | - Rosa M Lamuela-Raventós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, -UB, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Ascensión Marcos
- Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Guillermo Sáez
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Odontology, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
| | | | - Miguel Ruiz-Canela
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Estefania Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Ismael Alvarez-Alvarez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Javier Díez-Espino
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - José V Sorlí
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Josep Basora
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Olga Castañer
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Eva María Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Maria Angeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Antonio García-Rios
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
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Monroy M, Ruiz MA, Rejas J, Soto J. Mapping of the Gastrointestinal Short Form Questionnaire (GSF-Q) into EQ-5D-3L and SF-6D in patients with gastroesophageal reflux disease. Health Qual Life Outcomes 2018; 16:177. [PMID: 30200982 PMCID: PMC6131951 DOI: 10.1186/s12955-018-1003-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 08/29/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The short, self-administered Gastroesophageal Reflux Disease (GERD) Symptom Frequency Questionnaire (GSFQ) is a specific Quality of Life (QoL) instrument which measures the impact of GERD symptoms on QoL. This study aims to map the specific scores in GSFQ into two generic instruments: SF-6D and EQ-5D-3 L, in order to obtain utility estimates derived from the GERD condition. METHOD A national representative sample of GERD patients was selected, stratified by gender, age (< 45, ≥45 years) and GERD severity (0-I, II-IV Savary-Miller score) for validation purposes. Age, gender, BMI, GERD diagnose, GERD severity, associated comorbidities and risk factors were recorded. GSFQ, SF-6D, EQ-5D-3 L, and the HRQoL Visual Analogue Scale (VAS) were answered by patients. Several mapping methods were estimated, regression using dummy variables, and linear, quadratic and cubic regression using optimal factor scores. The use of a GERD aggregated summary severity derived from the GSFQ was dimed the best predictor. Overall Mean Absolute Error (MAE), overall Mean Absolute Percentage Error (MAPE) were used as goodness-of-fit (GOF) indexes to compare models. RESULTS A total of 3405 patients were recruited by 490 clinicians. Mean age was 49 (±14.4) years and 49.8% were women. Reported comorbidities were clustered in 6 antecedents and 15 concomitant pathologies. Aggregation of levels for the frequency of symptoms items was found more suitable for estimation. Regression weights were found to follow a monotonous progressive pattern. Overall MAE ranged from 0.092 to 0.094 for SF-6D utility prediction and from 0.008 to 0.08 for EQ-5D-3 L, while MAPE values ranged from 27.9 to 29% for SF-6D and from 36.8 to 38.4% for EQ-5D-3 L. Cubic regression GOF demonstrated a better fit. CONCLUSIONS It is possible to translate specific GSFQ scores assessing GERD condition into generic SF-6D and EQ-5D-3 L utility values. Although regression using dummy variables is a suitable mapping procedure, other alternative mapping methods convey better fit, in particular cubic regression.
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Affiliation(s)
- Manuel Monroy
- Faculty of Psychology, Universidad Autónoma de Madrid, C/ Ivan Pavlov 6, 28049 Madrid, Spain
| | - Miguel A. Ruiz
- Faculty of Psychology, Universidad Autónoma de Madrid, C/ Ivan Pavlov 6, 28049 Madrid, Spain
| | - Javier Rejas
- Faculty of Economics, Universidad Calos III de Madrid, C/ Madrid, 126, 28903 Getafe, Madrid, Spain
| | - Javier Soto
- Faculty of Economics, Universidad Calos III de Madrid, C/ Madrid, 126, 28903 Getafe, Madrid, Spain
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Vera O, Jimenez J, Rodriguez-Antolin C, Pernia O, Rodriguez C, Soto J, Rosas R, Esteban-Rodriguez I, Perona R, Castro JD, Ibáñez-de-Cáceres I. Abstract 4413: DNA methylation of miR-7 is a mechanism involved in platinum response through MAFG overexpression in cancer cells. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-4413] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
One of the major limitations associated with platinum use is the resistance that almost invariably develops in different tumor types. In the current study, we sought to identify epigenetically regulated microRNAs as novel biomarkers of platinum resistance in lung and ovarian cancers, the ones with highest ratios of associated chemo-resistance. Experimental procedures: We combined transcriptomic data from microRNA and mRNA under the influence of an epigenetic reactivation treatment in a panel of four paired cisplatin -sensitive and -resistant cell lines, followed by real-time expression and epigenetic validations for accurate candidate selection in 19 human cancer cell lines. To identify specific candidate genes under miRNA regulation, we assembled “in silico” miRNAs and mRNAs sequences by using ten different algorithms followed by qRT-PCR validation. Functional assays of site-directed mutagenesis and luciferase activity, miRNAs precursor overexpression, silencing by antago-miR and cell viability were performed to confirm their specificity in gene regulation. Results were further explored in 187 primary samples obtained from ovarian tumors and controls. Results: We identified 4 candidates, miR-7, miR-132, miR-335 and miR-148a, which deregulation seems to be a common event in the development of resistance to cisplatin in both tumor types. miR-7 presented specific methylation in resistant cell lines, and was associated with poorer prognosis in ovarian cancer patients. Our experimental results strongly support the direct regulation of MAFG through miR-7 and their involvement in the development of CDDP resistance in human tumor cells. Conclusion: The basal methylation status of miR-7 before treatment may be a potential clinical epigenetic biomarker, predictor of the chemotherapy outcome to CDDP in ovarian cancer patients. To the best of our knowledge, this is the first report linking the regulation of MAFG by miRNA-7 and its role in chemotherapy response to CDDP. Furthermore, this data highlights the possible role of MAFG as a novel therapeutic target for platinum resistant tumors.
Citation Format: Olga Vera, Julia Jimenez, Carlos Rodriguez-Antolin, Olga Pernia, Carmen Rodriguez, Javier Soto, Rocio Rosas, Isabel Esteban-Rodriguez, Rosario Perona, Javier de Castro, Inmaculada Ibáñez-de-Cáceres. DNA methylation of miR-7 is a mechanism involved in platinum response through MAFG overexpression in cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4413.
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Affiliation(s)
- Olga Vera
- 1University Hospital La Paz, Madrid, Spain
| | | | | | | | | | | | | | | | - Rosario Perona
- 2Institute for Biomedical Research CSIC/UAM, Madrid, Spain
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Tejedor M, Cusso L, Nava A, Rojo A, Martin G, Uson C, Soto J, Gonzalez-Nicolas MA, Tejedor A. SuO023DYNAMIC NMR SPECTROSCOPY IN THE FOLLOW-UP OF ACUTE AND CHRONIC HYPOTONIC BRAIN EDEMA. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.suo023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marta Tejedor
- GI medicine, 2Hospital Infanta Elena, Valdemoro, Madrid, Spain
| | - Lorena Cusso
- Imagen medica, Hospital Universitario "Gregorio Marañon", Madrid, Spain
| | - Angel Nava
- Fac Medicina, Universidad Complutense, Madrid, Spain
| | | | | | - Clara Uson
- Fac Medicina, Universidad Complutense, Madrid, Spain
| | - Javier Soto
- Fac Medicina, Universidad Complutense, Madrid, Spain
| | | | - Alberto Tejedor
- Nephrology, Hospital Universitario Gregorio Marañon, Madrid, Spain
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Mendonça B, Rueggeberg F, Braga R, Soto J, Sebold M, Ambrosano G, Giannini M. Physical and adhesion properties of bulk-fill composites. Dent Mater 2018. [DOI: 10.1016/j.dental.2018.08.070] [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: 10/28/2022]
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Vera O, Jimenez J, Pernia O, Rodriguez-Antolin C, Rodriguez C, Sanchez Cabo F, Soto J, Rosas R, Lopez-Magallon S, Esteban Rodriguez I, Dopazo A, Rojo F, Belda C, Alvarez R, Valentin J, Benitez J, Perona R, De Castro J, Ibanez de Caceres I. DNA Methylation of miR-7 is a Mechanism Involved in Platinum Response through MAFG Overexpression in Cancer Cells. Am J Cancer Res 2017; 7:4118-4134. [PMID: 29158814 PMCID: PMC5695001 DOI: 10.7150/thno.20112] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/04/2017] [Indexed: 11/16/2022] Open
Abstract
One of the major limitations associated with platinum use is the resistance that almost invariably develops in different tumor types. In the current study, we sought to identify epigenetically regulated microRNAs as novel biomarkers of platinum resistance in lung and ovarian cancers, the ones with highest ratios of associated chemo-resistance. Methods: We combined transcriptomic data from microRNA and mRNA under the influence of an epigenetic reactivation treatment in a panel of four paired cisplatin -sensitive and -resistant cell lines, followed by real-time expression and epigenetic validations for accurate candidate selection in 19 human cancer cell lines. To identify specific candidate genes under miRNA regulation, we assembled “in silico” miRNAs and mRNAs sequences by using ten different algorithms followed by qRT-PCR validation. Functional assays of site-directed mutagenesis and luciferase activity, miRNAs precursor overexpression, silencing by antago-miR and cell viability were performed to confirm their specificity in gene regulation. Results were further explored in 187 primary samples obtained from ovarian tumors and controls. Results: We identified 4 candidates, miR-7, miR-132, miR-335 and miR-148a, which deregulation seems to be a common event in the development of resistance to cisplatin in both tumor types. miR-7 presented specific methylation in resistant cell lines, and was associated with poorer prognosis in ovarian cancer patients. Our experimental results strongly support the direct regulation of MAFG through miR-7 and their involvement in the development of CDDP resistance in human tumor cells. Conclusion: The basal methylation status of miR-7 before treatment may be a potential clinical epigenetic biomarker, predictor of the chemotherapy outcome to CDDP in ovarian cancer patients. To the best of our knowledge, this is the first report linking the regulation of MAFG by miRNA-7 and its role in chemotherapy response to CDDP. Furthermore, this data highlights the possible role of MAFG as a novel therapeutic target for platinum resistant tumors.
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Long BL, Li H, Mahadevan A, Tang T, Balotin K, Grandel N, Soto J, Wong SY, Abrego A, Li S, Qutub AA. GAIN: A graphical method to automatically analyze individual neurite outgrowth. J Neurosci Methods 2017; 283:62-71. [PMID: 28336360 DOI: 10.1016/j.jneumeth.2017.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 01/13/2017] [Revised: 03/18/2017] [Accepted: 03/18/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Neurite outgrowth is a metric widely used to assess the success of in vitro neural stem cell differentiation or neuron reprogramming protocols and to evaluate high-content screening assays for neural regenerative drug discovery. However, neurite measurements are tedious to perform manually, and there is a paucity of freely available, fully automated software to determine neurite measurements and neuron counting. To provide such a tool to the neurobiology, stem cell, cell engineering, and neuroregenerative communities, we developed an algorithm for performing high-throughput neurite analysis in immunofluorescent images. NEW METHOD Given an input of paired neuronal nuclear and cytoskeletal microscopy images, the GAIN algorithm calculates neurite length statistics linked to individual cells or clusters of cells. It also provides an estimate of the number of nuclei in clusters of overlapping cells, thereby increasing the accuracy of neurite length statistics for higher confluency cultures. GAIN combines image processing for neuronal cell bodies and neurites with an algorithm for resolving neurite junctions. RESULTS GAIN produces a table of neurite lengths from cell body to neurite tip per cell cluster in an image along with a count of cells per cluster. COMPARISON WITH EXISTING METHODS GAIN's performance compares favorably with the popular ImageJ plugin NeuriteTracer for counting neurons, and provides the added benefit of assigning neurites to their respective cell bodies. CONCLUSIONS In summary, GAIN provides a new tool to improve the robust assessment of neural cells by image-based analysis.
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Affiliation(s)
- B L Long
- Department of Bioengineering, Rice University, Houston, TX 77030 USA.
| | - H Li
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - A Mahadevan
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - T Tang
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - K Balotin
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - N Grandel
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - J Soto
- Department of Bioengineering, University of California, Berkeley, CA 94720 USA
| | - S Y Wong
- Department of Bioengineering, University of California, Berkeley, CA 94720 USA
| | - A Abrego
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
| | - S Li
- Department of Bioengineering, University of California, Los Angeles, CA 90095 USA
| | - A A Qutub
- Department of Bioengineering, Rice University, Houston, TX 77030 USA
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Aranda D, Román-Pérez J, López-Tocón I, Soto J, Avila F, Otero JC. Comment on “Elucidation of charge-transfer SERS selection rules by considering the excited state properties and the role of electrode potential” by M. Mohammadpour, M. H. Khodabandeh, L. Visscher and Z. Jamshidi, Phys. Chem. Chem. Phys., 2017, 19, 7833. Phys Chem Chem Phys 2017; 19:27888-27891. [DOI: 10.1039/c7cp03075d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Different theoretical tools for modelling the complex role of the electrode potential in SERS are highlighted.
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Affiliation(s)
- D. Aranda
- Universidad de Málaga
- Andalucía Tech
- Facultad de Ciencias
- Departamento de Química Física
- Unidad Asociada CSIC
| | - J. Román-Pérez
- Universidad de Málaga
- Andalucía Tech
- Facultad de Ciencias
- Departamento de Química Física
- Unidad Asociada CSIC
| | - I. López-Tocón
- Universidad de Málaga
- Andalucía Tech
- Facultad de Ciencias
- Departamento de Química Física
- Unidad Asociada CSIC
| | - J. Soto
- Universidad de Málaga
- Andalucía Tech
- Facultad de Ciencias
- Departamento de Química Física
- Unidad Asociada CSIC
| | - F. Avila
- Universidad de Málaga
- Andalucía Tech
- Facultad de Ciencias
- Departamento de Química Física
- Unidad Asociada CSIC
| | - J. C. Otero
- Universidad de Málaga
- Andalucía Tech
- Facultad de Ciencias
- Departamento de Química Física
- Unidad Asociada CSIC
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Ruiz MA, González-Porras JR, Aranguren JL, Franco E, Villasante F, Tuñón J, González-López TJ, de Salas-Cansado M, Soto J. Development and validation of a new questionnaire measuring treatment satisfaction in patients with non-valvular atrial fibrillation: SAFUCA®. Qual Life Res 2016; 26:767-778. [DOI: 10.1007/s11136-016-1474-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2016] [Indexed: 11/28/2022]
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Pinyol C, Cepeda JM, Roldan I, Roldan V, Jimenez S, Gonzalez P, Soto J. A Systematic Literature Review on the Cost-Effectiveness of Apixaban for Stroke Prevention in Non-valvular Atrial Fibrillation. Cardiol Ther 2016; 5:171-186. [PMID: 27457613 PMCID: PMC5125108 DOI: 10.1007/s40119-016-0066-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Economic evaluations are becoming increasingly important due to limitations in economic resources, the expense of many new treatments, the need to allocate health spending as effectively as possible, and the need to inform decision makers. Based on the data from the apixaban studies (ARISTOTLE and AVERROES), several economic evaluations have been performed in various countries to demonstrate the efficacy of apixaban versus warfarin and aspirin or other new oral anticoagulants (NOACs) for preventing stroke in patients with non-valvular atrial fibrillation (NVAF).The aim of this study was to perform a systematic literature review of published economic evaluations with apixaban in the indication of stroke prevention in patients with NVAF. METHODS A search in PubMed, Cochrane Library, Google Scholar, and Index Medicus Español was conducted in June 2015. Inclusion and exclusion criteria were established. The main characteristics were recorded for all relevant articles after being reviewed. In addition, a weighted version of the Drummond's checklist was used to further assess the quality of the selected studies. RESULTS After review, 26 cost-effectiveness analyses through Markov models were included; the identified economic evaluations represent different willingness-to-pay (WTP) thresholds, discount rates, medical costs, and healthcare systems. Apixaban was compared with warfarin/acenocoumarol in 7 of them (27%), with warfarin/NOACs in 14 (54%), with aspirin in 2 (8%), and with warfarin/aspirin in 3 (11%). Models were conducted from Europe (69%), USA (23%), Australia (4%), and Latin America (4%). All models reported cost/quality-adjusted life years (QALYs) gained, 92% reported using a payer perspective, and 8% using a societal perspective; the median quality score of the selected studies was 89 (out of 119), with a range of 55-103. In models performed in Europe, incremental cost-effectiveness ratios (ICERs) of apixaban versus warfarin ranged from €5607/QALY to €57,245/QALY, while ICERs versus aspirin ranged from being dominant to €7334/QALY. In models carried out in the USA, ICERs of apixaban versus warfarin ranged from being dominant to $93,063/QALY. CONCLUSION Different cost-effectiveness analyses suggest that apixaban is a cost-effective therapeutic option according to the WTP thresholds used in countries where cost-effectiveness analyses, were performed. FUNDING BMS and Pfizer.
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Affiliation(s)
| | - Jose Mª Cepeda
- Internal Medicine Department, Hospital Comarcal Vega Baja, Orihuela, Alicante, Spain
| | | | - Vanesa Roldan
- Hematology Department, Hospital Morales Meseguer, Murcia, Spain
| | - Silvia Jimenez
- Health Economics and Outcomes Research, Bristol-Myers Squibb, Madrid, Spain
| | - Paloma Gonzalez
- Health Economics and Outcomes Research, Bristol-Myers Squibb, Madrid, Spain
| | - Javier Soto
- Health Economics and Outcomes Research, Pfizer S.L.U., Madrid, Spain
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Soto J, Mohamed Ahmed A, Turner R, Desset-Brethes S, Winzenburg G, Orlu Gul M, Tuleu C. Can solubilizing excipients be used with the rat BATA model to assess the taste of poorly water-soluble drugs? Int J Pharm 2016. [DOI: 10.1016/j.ijpharm.2016.06.109] [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: 10/21/2022]
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Soto J, Winzenburg G, Turner R, Desset-Brèthes S, Sheng Y, Orlu-Gul M, Tuleu C. Assessing the bitter taste of medicines: A comparison between rat taste panels (via the brief-access taste aversion (BATA) model) and human taste panels. Int J Pharm 2016. [DOI: 10.1016/j.ijpharm.2016.06.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sheng Y, Soto J, Orlu Gul M, Cortina‐Borja M, Tuleu C, Standing JF. New generalized poisson mixture model for bimodal count data with drug effect: An application to rodent brief-access taste aversion experiments. CPT Pharmacometrics Syst Pharmacol 2016; 5:427-36. [PMID: 27472892 PMCID: PMC4999606 DOI: 10.1002/psp4.12093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 12/29/2022] Open
Abstract
Pharmacodynamic (PD) count data can exhibit bimodality and nonequidispersion complicating the inclusion of drug effect. The purpose of this study was to explore four different mixture distribution models for bimodal count data by including both drug effect and distribution truncation. An example dataset, which exhibited bimodal pattern, was from rodent brief-access taste aversion (BATA) experiments to assess the bitterness of ascending concentrations of an aversive tasting drug. The two generalized Poisson mixture models performed the best and was flexible to explain both under and overdispersion. A sigmoid maximum effect (Emax ) model with logistic transformation was introduced to link the drug effect to the data partition within each distribution. Predicted density-histogram plot is suggested as a model evaluation tool due to its capability to directly compare the model predicted density with the histogram from raw data. The modeling approach presented here could form a useful strategy for modeling similar count data types.
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Affiliation(s)
- Y Sheng
- Department of PharmaceuticsUCL School of PharmacyLondonUnited Kingdom
- Center for Drug Clinical Research, Shanghai University of Chinese MedicineShanghaiChina
| | - J Soto
- Department of PharmaceuticsUCL School of PharmacyLondonUnited Kingdom
| | - M Orlu Gul
- Department of PharmaceuticsUCL School of PharmacyLondonUnited Kingdom
| | - M Cortina‐Borja
- Population, Policy, and Practice Programme, Institute of Child Health, UCLLondonUnited Kingdom
| | - C Tuleu
- Department of PharmaceuticsUCL School of PharmacyLondonUnited Kingdom
| | - JF Standing
- Department of PharmaceuticsUCL School of PharmacyLondonUnited Kingdom
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Li B, Yu H, Jara H, Soto J, Anderson S. WE-FG-206-12: Enhanced Laws Textures: A Potential MRI Surrogate Marker of Hepatic Fibrosis in a Murine Model. Med Phys 2016. [DOI: 10.1118/1.4957942] [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: 11/07/2022] Open
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Elías I, Oyagüez I, Alvarez-Sala LA, García-Bragado F, Navarro A, González P, De Andrés-Nogales F, Soto J. Cost-effectiveness analysis of apixaban compared to low-molecularweight heparins and vitamin k antagonists for treatment and secondary prevention of venous thromboembolism. Farm Hosp 2016; 40:187-208. [PMID: 27145388 DOI: 10.7399/fh.2016.40.3.10461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Cost-effectiveness analysis of a 6-month treatment of apixaban (10 mg/12h, first 7 days; 5 mg/12h afterwards) for the treatment of the first event of venous thromboembolism (VTE) and prevention of recurrences, versus low-molecular-weight heparins/vitamin K antagonists treatment (LMWH/VKA). MATERIAL AND METHODS A lifetime Markov model with 13 health states was used for describing the course of the disease. Efficacy and safety data were obtained from AMPLIFY and AMPLIFY-EXT clinical trials; health outcomes were measured as life years gained (LYG) and quality-adjusted life years (QALY). The chosen perspective of this analysis has been the Spanish National Health System (NHS). Drugs, management of VTE and complications costs were obtained from several Spanish data sources (€, 2014). A 3% discount rate was applied to health outcomes and costs. Univariate and probabilistic sensitivity analyses (SA) were performed in order to assess the robustness of the results. RESULTS Apixaban was the most effective therapy with 7.182 LYG and 5.865 QALY, versus 7.160 LYG and 5.838 QALYs with LMWH/VKA. Furthermore, apixaban had a lower total cost (€13,374.70 vs €13,738.30). Probabilistic SA confirmed dominance of apixaban (led to better health outcomes with less associated costs) in 89% of the simulations. CONCLUSIONS Apixaban 5 mg/12h versus LMWH/VKA was an efficient therapeutic strategy for the treatment and prevention of recurrences of VTE from the NHS perspective.
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Affiliation(s)
- Isabel Elías
- Pharmacoeconomics & Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, Madrid..
| | - Itziar Oyagüez
- Pharmacoeconomics & Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, Madrid..
| | - Luis Antonio Alvarez-Sala
- Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Madrid..
| | | | - Andrés Navarro
- Servicio de Farmacia. Hospital General Universitario de Elche, Alicante..
| | - Paloma González
- Departamento Health Economics, Bristol-Myers Squibb, Madrid..
| | | | - Javier Soto
- Departamento Health Economics, Pfizer, Alcobendas, Madrid. Spain..
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Soto J, Rodriguez-Antolin C, Vallespín E, de Castro Carpeño J, Ibanez de Caceres I. The impact of next-generation sequencing on the DNA methylation-based translational cancer research. Transl Res 2016; 169:1-18.e1. [PMID: 26687736 DOI: 10.1016/j.trsl.2015.11.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 10/29/2015] [Accepted: 11/14/2015] [Indexed: 01/08/2023]
Abstract
Epigenetics is currently in an exponential phase of growth, constituting one of the most promising fields in science, particularly in cancer research. Impaired epigenetic processes can lead to abnormal gene activity or inactivity, causing cellular disorders that are closely associated with tumor initiation and progression. Thus, there is a pivotal role of massive sequencing techniques for epigenetics, which aim to find novel biomarkers, factors of prognosis and prediction, and targets for achieving personalized treatments. We present a brief description of the evolution of next-generation sequencing technologies and its coupling with DNA methylation analysis techniques, highlighting its future in translational medicine and presenting significant findings in several malignancies. We also expose critical topics related to the implementation of these approaches, which is expected to be affordable for most research centers in the near future.
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Affiliation(s)
- Javier Soto
- Cancer Epigenetics Laboratory, INGEMM, La Paz University Hospital, Madrid, Spain; Biomarkers and Experimental Therapeutics in Cancer, IdiPAZ, Madrid, Spain
| | - Carlos Rodriguez-Antolin
- Cancer Epigenetics Laboratory, INGEMM, La Paz University Hospital, Madrid, Spain; Biomarkers and Experimental Therapeutics in Cancer, IdiPAZ, Madrid, Spain
| | - Elena Vallespín
- Structural and Functional Genomics, INGEMM-IdiPAZ-CIBERER, La Paz University Hospital, Madrid, Spain
| | | | - Inmaculada Ibanez de Caceres
- Cancer Epigenetics Laboratory, INGEMM, La Paz University Hospital, Madrid, Spain; Biomarkers and Experimental Therapeutics in Cancer, IdiPAZ, Madrid, Spain.
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Pernía O, Belda-Iniesta C, Pulido V, Cortes-Sempere M, Rodriguez C, Vera O, Soto J, Jiménez J, Taus A, Rojo F, Arriola E, Rovira A, Albanell J, Macías MT, de Castro J, Perona R, Ibañez de Caceres I. Methylation status of IGFBP-3 as a useful clinical tool for deciding on a concomitant radiotherapy. Epigenetics 2015; 9:1446-53. [PMID: 25482372 PMCID: PMC4622698 DOI: 10.4161/15592294.2014.971626] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The methylation status of the IGFBP-3 gene is strongly associated with cisplatin sensitivity in patients with non-small cell lung cancer (NSCLC). In this study, we found in vitro evidence that linked the presence of an unmethylated promoter with poor response to radiation. Our data also indicate that radiation might sensitize chemotherapy-resistant cells by reactivating IGFBP-3-expression through promoter demethylation, inactivating the PI3K/AKT pathway. We also explored the IGFBP-3 methylation effect on overall survival (OS) in a population of 40 NSCLC patients who received adjuvant therapy after R0 surgery. Our results indicate that patients harboring an unmethylated promoter could benefit more from a chemotherapy schedule alone than from a multimodality therapy involving radiotherapy and platinum-based treatments, increasing their OS by 2.5 y (p = .03). Our findings discard this epi-marker as a prognostic factor in a patient population without adjuvant therapy, indicating that radiotherapy does not improve survival for patients harboring an unmethylated IGFBP-3 promoter.
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Affiliation(s)
- Olga Pernía
- a Cancer Epigenetics Laboratory, INGEMM ; University Hospital La Paz ; Madrid , Spain
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Ibáñez-de-Cáceres MI, Pernía O, Belda-Iniesta C, Vera O, Jimenez J, Rodriguez C, Soto J, de Castro J, Macias T, Rojo F, Albanell J, Perona R. Abstract 3443: A new medical tool to discriminate on a radiotherapy concomitant treatment for non-small cell lung cancer patients. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-3443] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: The radioresistance of non-small cell lung cancer cells is a less explored and poorly defined field compared with drug resistance. Our group has previously reported that the loss of IGFBP-3 expression by promoter hypermethylation results in reduced tumor cell sensitivity to cisplatin in NSCLC, however the role of the IGF-I/IGBP-3 axe on radiosensitivity in cancer is controversial because of the differing results when various tumor types are evaluated. The purpose of the present study is to investigate the role of radiotherapy on the biology of IGFBP-3 promoter methylation and its clinical value as a potential tool for deciding on a concomitant radiotherapy after NSCLC surgery.
Experimental procedure: In the present study we have worked with 5 human cancer cell lines, 40 NSCLC surgical sample patients with known response to CDDP and radiotherapy treatments and 10 control samples with non neoplastic pathology. We have study the relationship between a dose-response radiotherapy treatment and the IGFBP-3 gene expression regulated by promoter methylation measured by Radiation-clonogenic cell survival assays, RT-PCR, bisulfite modification and quantitative methylation specific PCR. We have also studied, the activation of the IGFIR, ERK and PI3K/AKT pathways through the analysis of the AKT, pAKT, pERK, ERK, pIGFIR and IGFIR protein levels by Western-Blot analysis. Additionally, in order to provide a helpful tool that enables clinicians to identify patients with a potential response to radiotherapy, we have used The TCGA annotation to correlate the IGFBP-3 methylation score of the NSCLC patients with their clinical-pathological parameters.
Results: Our results suggest in vitro evidence that linked the presence of an IGFBP-3 unmethylated promoter with poor response to radiation. Radiation might sensitize chemotherapy-resistant cells by reactivating IGFBP-3-expression through promoter demethylation, inactivating the PI3K/AKT pathway. Our translational results indicate that patients harboring an unmethylated promoter could benefit more from a chemotherapy schedule alone than from a multimodality therapy involving radiotherapy and platinum-based treatments, increasing their OS by 2.5 years (p = .03).
Conclusion: Our findings indiucate that radiotherapy does not improve survival for patients harboring an unmethylated IGFBP-3 promoter.
Citation Format: Maria I. Ibáñez-de-Cáceres, Olga Pernía, Cristobal Belda-Iniesta, Olga Vera, Julia Jimenez, Carlos Rodriguez, Javier Soto, Javier de Castro, Teresa Macias, Federico Rojo, Joan Albanell, Rosario Perona. A new medical tool to discriminate on a radiotherapy concomitant treatment for non-small cell lung cancer patients. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3443. doi:10.1158/1538-7445.AM2015-3443
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Diaz FM, Moreno O, Muñoz M, Fernandez R, Soto J, Colmenero M. Analysis of the interhospital transfer times in patients with ST-elevation acute coronary syndrome (STEMI) for undergoing urgent coronariography. Crit Care 2015. [PMCID: PMC4470675 DOI: 10.1186/cc14243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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