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著者: Hayashino Y, Fukuhara S, Akizawa T, Asano Y, Wakita T, Onishi Y, Kurokawa K; CAP-KD study group.
雑誌名: Diabetes Res Clin Pract. 2010 Nov;90(2):154-9. doi: 10.1016/j.diabres.2010.07.007. Epub 2010 Aug 13.
Abstract/Text
AIMS: AST-120, an oral adsorbent currently on-label only in Asian countries with phase III trials ongoing in the US, slows renal disease progression in patients with diabetes and advanced-stage chronic kidney disease (CKD). The objective of this study is to evaluate the cost-effectiveness of using AST-120 to treat patients with type 2 diabetes and advanced-stage CKD.
METHODS: We used Markov model simulating the progression of diabetic nephropathy. Data were obtained from randomized trials estimating the progression of diabetic nephropathy with and without AST-120, and published literature. The base population was patients 60 years of age with type 2 diabetes and Stages 3 and 4 CKD.
RESULTS: Treating patients with diabetes and advanced-stage CKD was found to be a dominant strategy, and quality of life improved further and more money was saved (0.22 quality-adjusted life years [QALYs] and $15,019 per patient) using AST-120 than the control strategy. Sensitivity analysis results were robust with regard to cost, adherence, and quality of life associated with AST-120 therapy, as well as age at diagnosis. The model was relatively sensitive to the effectiveness of AST-120.
CONCLUSIONS: Treating patients with type 2 diabetes and advanced-stage CKD with AST-120 appears to extend life and reduce costs.
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
PMID 20708813 Diabetes Res Clin Pract. 2010 Nov;90(2):154-9. doi: 10.1016/j.diabres.2010.07.007. Epub 2010 Aug 13.
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