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Alharbi A, Yousef A, Zubani A, Alzahrani M, Al-Hindi M, Alharbi S, Alahmadi T, Alabdulkarim H, Kazmierska P, Beuvelet M. Respiratory Syncytial Virus (RSV) Burden in Infants in the Kingdom of Saudi Arabia and the Impact of All-Infant RSV Protection: A Modeling Study. Adv Ther 2024; 41:1419-1435. [PMID: 38356106 PMCID: PMC10960893 DOI: 10.1007/s12325-024-02798-w] [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: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) represents a considerable burden on the healthcare system and hospital resources. This study explored the impact of universal immunoprophylaxis with long-acting monoclonal antibody (nirsevimab) during infants' first RSV season on RSV-induced health events and related costs in the Kingdom of Saudi Arabia (KSA). METHODS The burden of RSV-induced health events and related costs under the current standard of practice (SoP) and the impact of universal immunoprophylaxis with nirsevimab was estimated using a static decision-analytic model in a cohort of infants experiencing their first RSV season in the KSA. The model estimated hospital admissions (including pediatric intensive care unit [PICU] admissions and mechanical ventilation [MV]), emergency room (ER) visits, primary care (PC) visits, long-term sequelae, and RSV mortality. RESULTS The model estimated that under the current SoP, RSV results in 17,179-19,607 hospitalizations (including 2932-3625 PICU and 172-525 MV admissions), 57,654-191,115 ER visits, 219,053-219,970 PC visits, 14 deaths, 12,884-14,705 cases of recurrent wheezing, and a total cost of SAR 480-619 million. Universal nirsevimab immunoprophylaxis was estimated to avert 58% of hospitalizations (58% PICU admissions, 58% MV episodes), 53% of ER visits, 53% of PC visits, 58% of episodes of recurrent wheezing, 8 deaths, and result in savings of SAR 274-343 million in total healthcare cost. CONCLUSION Compared with current SoP, an nirsevimab immunoprophylaxis strategy in the KSA for all infants during their first RSV season was estimated to dramatically decrease healthcare resource use, and economic burden associated with RSV.
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Affiliation(s)
- Adel Alharbi
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdullah Yousef
- King Fahd University Hospital, Al Khobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amal Zubani
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Mohammad Al-Hindi
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
- Research and Development, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Turki Alahmadi
- Pediatric Department, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Pediatric Department, Faculty of Medicine, King Abdulaziz University Hospital, Rabigh, Saudi Arabia
| | - Hana Alabdulkarim
- Drug Policy and Economics Center, National Guard Health Affairs, Riyadh, Saudi Arabia
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
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Armstrong A, Fahrbach K, Leonardi C, Augustin M, Neupane B, Kazmierska P, Betts M, Freitag A, Kiri S, Taieb V, Slim M, Gomez NN, Warren RB. Efficacy of Bimekizumab and Other Biologics in Moderate to Severe Plaque Psoriasis: A Systematic Literature Review and a Network Meta-Analysis. Dermatol Ther (Heidelb) 2022; 12:1777-1792. [PMID: 35798920 PMCID: PMC9357587 DOI: 10.1007/s13555-022-00760-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 05/16/2022] [Accepted: 06/08/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Biologic treatments are increasingly being used in the management of moderate to severe plaque psoriasis (PSO). Bimekizumab is a selective inhibitor of both interleukin (IL)-17A and IL-17F approved for the treatment of moderate to severe PSO. Although bimekizumab trials provide comparisons to secukinumab, adalimumab and ustekinumab, there are no further head-to-head comparisons of bimekizumab to other biologics. This network meta-analysis (NMA) aimed to compare the short-term efficacy of bimekizumab versus other biologic systemic therapies for moderate to severe PSO. METHODS A systematic literature review was conducted to identify randomised controlled trials (RCTs) in patients with moderate to severe PSO. MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and the Database of Systematic Reviews and PsycINFO were searched on July 1, 2020. An enhanced multinomial Bayesian NMA model was used to evaluate the comparative efficacy in 50%, 75%, 90% and 100% improvement from baseline Psoriasis Area and Severity Index (PASI 50/75/90/100) at 10-16 weeks. The model was also adjusted for baseline risk, given the variable placebo responses across the trials. RESULTS Eighty-six RCTs (including 34,476 patients) were included in the NMA. IL-17 and IL-23 inhibitors were the most effective treatments across all PASI levels. At 10-16 weeks, bimekizumab had the highest probability of achieving PASI 75 (92.3%), PASI 90 (84.0%) and PASI 100 (57.8%). Bimekizumab demonstrated statistical superiority over all biologics in achieving PASI 90 and PASI 100 thresholds. For PASI 75, the benefit of bimekizumab was statistically significant compared to all other treatments except risankizumab and ixekizumab. CONCLUSION This analysis demonstrated that IL-17 and IL-23 inhibitors were highly effective in achieving short-term improvement among patients with moderate to severe PSO. Patients receiving bimekizumab were significantly more likely to achieve PASI 90 or PASI 100 within 10-16 weeks of the first injection than all other biologics.
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Affiliation(s)
- April Armstrong
- Keck School of Medicine of USC, Dermatology, Los Angeles, CA, USA
| | - Kyle Fahrbach
- Evidera, Inc, 140 Kendrick St, 3rd Floor, Needham, MA, 02494, USA.
| | - Craig Leonardi
- Central Dermatology and Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | | | - Marissa Betts
- Evidera, Inc, 140 Kendrick St, 3rd Floor, Needham, MA, 02494, USA
| | | | | | | | - Mahmoud Slim
- Evidera (Evidence Synthesis), St-Laurent, Canada
| | | | - Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
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Kongnakorn T, Sarri G, Freitag A, Marczell K, Kazmierska P, Masters E, Pawar V, Zhang X. Modeling Challenges in Cost-Effectiveness Analysis of First-Line Immuno-Oncology Therapies in Non-small Cell Lung Cancer: A Systematic Literature Review. Pharmacoeconomics 2022; 40:183-201. [PMID: 34595671 PMCID: PMC8795065 DOI: 10.1007/s40273-021-01089-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The introduction of immuno-oncology (IO) therapies has changed the treatment landscape of non-small cell lung cancer (NSCLC). Numerous cost-effectiveness analyses (CEAs) and technology appraisals (TAs) evaluating IO therapies have been recently published. OBJECTIVE We reviewed economic models of first-line (1L) IO therapies for previously untreated advanced or metastatic NSCLC to identify methodological challenges associated with modeling cost effectiveness from published literature and TAs and to make recommendations for future CEAs in this disease area. METHODS A systematic literature review was conducted following Cochrane and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched MEDLINE, Embase, EconLit (January 2009-January 2020), and select conferences (since 2016) for CEAs of 1L IO treatments in patients with recurrent or metastatic, epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK) mutation-negative NSCLC, published in English. TAs from England, Scotland, Canada, Australia, Germany, and France were also examined. Two reviewers screened the results and extracted the data. The quality of the CEAs was described using the Drummond checklist. RESULTS In total, 46 records reporting on 38 unique models met protocol-defined criteria and were included. Five models adjusted for treatment switching or crossover in base-case analyses, and the remainder considered treatment switching or crossover to represent clinical practice and made no adjustment. Seven models used external real-world data for survival modeling or extrapolation validation. Six models that assumed long-term treatment benefit stopped at 3 or 5 years after initiation. Seven models used the observed time-on-treatment distribution from the trial, and eight used progression-free survival for treatment duration. All models compared one or more IO monotherapies or combination therapies with chemotherapy. Only one study directly compared different IO agents but did not consider the concordance issue across programmed death-ligand 1 (PD-L1) testing methods. Utilities were modeled by health state in 12 models, four applied a time-to-death approach, and ten explored both. None applied cure models. CONCLUSION Variations in methodological challenges were seen across studies. Previous models took approaches that were followed in subsequent models, such as a 2-year stopping rule of IO duration or treatment-effect waning. Challenges such as heterogeneity in PD-L1 testing and survival extrapolation and validation using real-world data should be further considered for future models in advanced or metastatic NSCLC.
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Affiliation(s)
| | | | | | | | | | | | - Vivek Pawar
- EMD Serono Research & Development Institute, Inc., 45A Middlesex Turnpike, Billerica, 01821, MA, USA
| | - Xinke Zhang
- EMD Serono Research & Development Institute, Inc., 45A Middlesex Turnpike, Billerica, 01821, MA, USA.
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Koufopoulou M, Miranda PAP, Kazmierska P, Deshpande S, Gaitonde P. Clinical evidence for the first-line treatment of advanced urothelial carcinoma: Current paradigms and emerging treatment options. Cancer Treat Rev 2020; 89:102072. [PMID: 32769039 DOI: 10.1016/j.ctrv.2020.102072] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 03/24/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients with advanced urothelial carcinoma (UC) have poor outcomes, with 5-year survival rates of <5% for those with metastatic, stage IV disease. We have reviewed current treatment paradigms and emerging treatment options for these patients. METHODS The websites of seven national or international organizations were searched for metastatic UC treatment guidelines. Systematic literature reviews were conducted to identify evidence from randomized controlled trials (RCTs) of chemotherapy for patients with previously untreated, unresectable, stage IV UC. Searches included congress databases and articles published between 1990 and 2018. In order to align with the latest treatment paradigms in first-line advanced UC, a focused literature search was conducted to identify evidence supporting immuno-oncology (IO) agents. RESULTS For advanced UC, guidelines universally recommend cisplatin-based chemotherapy as first-line treatment for eligible patients and carboplatin-based regimens for those unfit to receive cisplatin. Despite the evaluation of a number of different cytotoxic regimens over the years, including triplet combinations, survival outcomes have not improved markedly with chemotherapy. Median overall survival with standard of care chemotherapy is ~13 months. Based on the results of single-arm, phase II studies, recent treatment guidelines have included atezolizumab (anti-PD-L1) and pembrolizumab (anti-PD-1) as first-line options for cisplatin-ineligible patients whose tumors express high levels of PD-L1. However, emerging evidence from RCTs of IO agents, including both cisplatin-eligible and cisplatin-ineligible patients, suggest that survival times exceeding 20 months are possible. CONCLUSIONS After having reached a plateau with chemotherapy, the treatment landscape for advanced UC is evolving. Survival outcomes for patients with advanced UC are improving with treatment modalities involving IO agents.
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Affiliation(s)
| | | | | | - Sohan Deshpande
- Evidence Synthesis, Modeling & Communication, Evidera, London, UK
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Caban B, Staszelis A, Kazmierska P, Kowalczyk T, Konopacki J. Postnatal Development of the Posterior Hypothalamic Theta Rhythm and Local Cell Discharges in Rat Brain Slices. Dev Neurobiol 2018; 78:1049-1063. [DOI: 10.1002/dneu.22628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Bartosz Caban
- Faculty of Biology and Environmental Protection, Department of Neurobiology; University of Lodz; Lodz Poland
| | - Agata Staszelis
- Faculty of Biology and Environmental Protection, Department of Neurobiology; University of Lodz; Lodz Poland
| | - Paulina Kazmierska
- Faculty of Biology and Environmental Protection, Department of Neurobiology; University of Lodz; Lodz Poland
| | - Tomasz Kowalczyk
- Faculty of Biology and Environmental Protection, Department of Neurobiology; University of Lodz; Lodz Poland
| | - Jan Konopacki
- Faculty of Biology and Environmental Protection, Department of Neurobiology; University of Lodz; Lodz Poland
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Kazmierska P, Konopacki J. Development of theta rhythm in hippocampal formation slices perfused with 5-HT1A antagonist, (S)WAY 100135. Brain Res 2015; 1625:142-50. [DOI: 10.1016/j.brainres.2015.08.041] [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] [Received: 04/22/2015] [Revised: 07/28/2015] [Accepted: 08/28/2015] [Indexed: 12/01/2022]
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Bocian R, Kazmierska P, Kłos-Wojtczak P, Kowalczyk T, Konopacki J. Orexinergic theta rhythm in the rat hippocampal formation: In vitro and in vivo findings. Hippocampus 2015; 25:1393-406. [PMID: 25820995 DOI: 10.1002/hipo.22459] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 02/02/2023]
Abstract
Previous in vivo data suggested that orexin neuropeptides (ORX(A) and ORX(B) ) synthetized in hypothalamic neurons were involved in the mechanism of generation of the hippocampal formation theta rhythm. Surprisingly, this suggestion has never been directly proved by experiments using intraseptal or intrahippocampal administration of orexins. In this study, involving the use of in vitro hippocampal formation slices and in vivo model of anesthetized rat, we provide the first convergent electropharmacological evidence that in the presence of both ORX(A) and ORX(B) the hippocampal formation neuronal network is capable of producing oscillations in the theta band. This effect of orexin peptides was antagonized by selective blockers of orexin receptors (OX1 R and OX2 R), SB 334867 and TCS OX2 29, respectively. These results provide evidence for a novel, orexinergic mechanism responsible for the production of theta rhythm in the hippocampal formation neuronal network.
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Affiliation(s)
- Renata Bocian
- Department of Neurobiology, Faculty of Biology and Environmental Protection, University of Lodz, Poland
| | - Paulina Kazmierska
- Department of Neurobiology, Faculty of Biology and Environmental Protection, University of Lodz, Poland
| | - Paulina Kłos-Wojtczak
- Department of Neurobiology, Faculty of Biology and Environmental Protection, University of Lodz, Poland
| | - Tomasz Kowalczyk
- Department of Neurobiology, Faculty of Biology and Environmental Protection, University of Lodz, Poland
| | - Jan Konopacki
- Department of Neurobiology, Faculty of Biology and Environmental Protection, University of Lodz, Poland
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Kazmierska P, Konopacki J. Development of NMDA-induced theta rhythm in hippocampal formation slices. Brain Res Bull 2013; 98:93-101. [DOI: 10.1016/j.brainresbull.2013.07.010] [Citation(s) in RCA: 15] [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] [Received: 04/30/2013] [Revised: 07/11/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022]
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Macias M, Blazejczyk M, Kazmierska P, Caban B, Skalecka A, Tarkowski B, Rodo A, Konopacki J, Jaworski J. Spatiotemporal characterization of mTOR kinase activity following kainic acid induced status epilepticus and analysis of rat brain response to chronic rapamycin treatment. PLoS One 2013; 8:e64455. [PMID: 23724051 PMCID: PMC3665782 DOI: 10.1371/journal.pone.0064455] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [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: 10/11/2012] [Accepted: 04/15/2013] [Indexed: 01/09/2023] Open
Abstract
Mammalian target of rapamycin (mTOR) is a protein kinase that senses nutrient availability, trophic factors support, cellular energy level, cellular stress, and neurotransmitters and adjusts cellular metabolism accordingly. Adequate mTOR activity is needed for development as well as proper physiology of mature neurons. Consequently, changes in mTOR activity are often observed in neuropathology. Recently, several groups reported that seizures increase mammalian target of rapamycin (mTOR) kinase activity, and such increased activity in genetic models can contribute to spontaneous seizures. However, the current knowledge about the spatiotemporal pattern of mTOR activation induced by proconvulsive agents is rather rudimentary. Also consequences of insufficient mTOR activity on a status epilepticus are poorly understood. Here, we systematically investigated these two issues. We showed that mTOR signaling was activated by kainic acid (KA)-induced status epilepticus through several brain areas, including the hippocampus and cortex as well as revealed two waves of mTOR activation: an early wave (2 h) that occurs in neurons and a late wave that predominantly occurs in astrocytes. Unexpectedly, we found that pretreatment with rapamycin, a potent mTOR inhibitor, gradually (i) sensitized animals to KA treatment and (ii) induced gross anatomical changes in the brain.
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Affiliation(s)
- Matylda Macias
- Laboratory of Molecular and Cell Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
| | - Magdalena Blazejczyk
- Laboratory of Molecular and Cell Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
| | | | - Bartosz Caban
- Department of Neurobiology, University of Lodz, Lodz, Poland
| | - Agnieszka Skalecka
- Laboratory of Molecular and Cell Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
| | - Bartosz Tarkowski
- Laboratory of Molecular and Cell Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
| | - Anna Rodo
- Department of Pathology and Veterinary Diagnostics, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Jan Konopacki
- Department of Neurobiology, University of Lodz, Lodz, Poland
| | - Jacek Jaworski
- Laboratory of Molecular and Cell Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
- * E-mail:
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Kazmierska P, Grebowski J, Konopacki J. Does an anti-oxidant ascorbic acid improve the condition of hippocampal formation slice preparations? A micro-EEG approach. Int J Exp Pathol 2012; 93:406-13. [PMID: 23083000 DOI: 10.1111/j.1365-2613.2012.00838.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 07/01/2012] [Indexed: 11/29/2022] Open
Abstract
The objective of this study was to assess whether ascorbic acid (AA), an intracellular anti-oxidant critical for neuronal protection, when added to artificial cerebrospinal fluid (ACSF), is able to protect hippocampal (HPC) formation slice preparations from ageing. In this research, the micro-electroencephalographic (EEG) technique was applied. Experiments were performed on 72 HPC formation slices obtained from 12 male Wistar rats. Two series of experiments were conducted: the control experiment, in which ACSF was used as an incubation medium, and the research one, in which ACSF was supplemented with 200 μM AA. The experimental model of carbachol-induced EEG theta rhythm was applied. The following parameters of theta rhythm after 15, 30 and 45 min of recording were analysed: frequency, power, time duration of theta epochs and time duration of intervals between theta epochs. The results show that AA causes a statistically significant decrease in the power of theta rhythm after 15, 30 and 45 min of recording. The time duration of intervals between theta epochs was almost twice as long in slices incubated in ACSF + AA than in ACSF after 45 min of recording. The data obtained indicate that AA does not improve the condition of HPC slices. On the contrary, it worsens the ability of slice preparations to generate theta oscillations. We hypothesize that our data may result from the Fenton reaction or changes in the conformation of connexins.
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Bocian R, Posluszny A, Kowalczyk T, Kazmierska P, Konopacki J. Gap junction modulation of hippocampal formation theta and local cell discharges in anesthetized rats. Eur J Neurosci 2011; 33:471-81. [PMID: 21226774 DOI: 10.1111/j.1460-9568.2010.07545.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Renata Bocian
- Department of Neurobiology, The University of Łódź, Rewolucji 1905 no. 66, Łódź 90-222, Poland
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