Impact of chondroitin sulphate on health utility in patients with knee osteoarthritis: towards economic analysis.

in Journal of Medical Economics (2009), 12(4), 356-360

Abstract Objectives: The first objective was to assess the effect of the chondroitin 4 and 6 sulphate (CS) on health-related quality of life using utility values in patients with knee osteoarthritis (OA ... [more ▼]

Abstract Objectives: The first objective was to assess the effect of the chondroitin 4 and 6 sulphate (CS) on health-related quality of life using utility values in patients with knee osteoarthritis (OA) during a 24-month treatment course. The second objective was, using these data, to conduct economic analyses. Methods: Data from the STOPP study was used. This study was a randomised, double-blind, placebo (PL) -controlled trial of 2-year duration. In the STOPP study, authors assessed quality of life using the Western Ontario and McMaster Osteoarthritis Index (WOMAC). WOMAC scores were translated into Health Utility Index (HUI) scores using a specific formula. Incremental cost effectiveness ratio (ICER) was calculated taking into account the cost of CS and its effect on HUI scores, compared to PL. Results: At baseline, the mean (SD) HUI scores were 0.59 (0.17), and 0.59 (0.18) for the PL and CS groups, respectively (p=0.31 between the two groups). The mean (SD) HUI scores changes from baseline to 6 months were 0.02 (0.02), and 0.05 (0.01) for the PL and CS groups, respectively (p=0.03). After 24 months of follow-up, HUI score increases by 0.04 (0.02) in the PL group and by 0.05 (0.02) in the CS group (p=0.37). Using the price bracket of CS in Europe, ICER assessment always resulted in a cost below euro30,000 per QALY gained, after 6, 12 and 24 months of treatment. Conclusion: CS treatment increases health utilities in patients with knee OA compared to PL over the first 6 months of treatment. Economic evaluation based on these data suggests that CS treatment could be considered as cost-effective in patients with knee OA up to a period of 24 months. A limitation in this study is the absence of direct utility assessment as well as the absence of effective treatment as comparator. [less ▲]

Loss of hip bone mineral density over time is associated with spine and hip fracture incidence in osteoporotic postmenopausal women.

in European journal of epidemiology (2009), 24

The objective of the study assess the relationship between bone mineral density (BMD) loss over time and fracture incidence in postmenopausal women. This is a posthoc analysis that includes women from the ... [more ▼]

The objective of the study assess the relationship between bone mineral density (BMD) loss over time and fracture incidence in postmenopausal women. This is a posthoc analysis that includes women from the placebo group of two large randomized controlled trials having assessed the efficacy of a new anti-osteoporotic drug. BMD was assessed every 6 months during 3 years at the lumbar spine, the femoral neck and the total proximal femur. Vertebral fractures were assessed using a semiquantitative method. Hip fractures were based on written documentation. All patients received calcium and vitamin D. In the present study that included 1,775 patients (with complete data at baseline and after 3 years), the logistic regression analysis, adjusted for covariates, showed that 3-year change in lumbar BMD was not statistically associated with the new vertebral fractures after 3 years. However, femoral neck and total proximal femur BMD changes was statistically correlated with the incidence of new vertebral fractures (P < 0.001). When considering change in BMD after the first year of follow-up, a decrease in total proximal femur BMD was statistically associated with an increase in the incidence of new vertebral fractures during the last 2 years of follow-up (P = 0.048). The 3-year change in femoral neck and total proximal BMD was statistically correlated with the incidence of hip and fragility fracture after 3 years (all P < 0.001). In this elderly osteoporotic population receiving calcium and vitamin D, a decrease in hip BMD after 1 or 3 year of follow-up, is associated with an increased risk of fracture incidence. However, spine BMD changes do not influence vertebral fracture incidence. [less ▲]

Impact of medication non-compliance and non-persistence on pharmacoeconomic evaluations in osteoporosis

in Osteoporosis International (2008, December), 19(S2), 282

Cost-utility of strontium ranelate versus risedronate in the treatment of postmenopausal osteoporotic women

in Osteoporosis International (2008, December), 19(S2), 450

Association between changes in bone mineral density and fracture incidence in postmenopausal osteoporotic women receiving calcium and vitamin D: a 3-year follow-up study

in Arthritis and Rheumatism (2008, October), 58(Suppl.1), 743

Efficiency and recommendations for osteoporosis screening strategy

Conference (2008, July)

Relationship between long-term changes in femoral neck bone mineral density and hip fracture incidence in untreated postmenopausal osteoporotic women

in Annals of the Rheumatic Diseases (2008, June), 67(Suppl.II), 403

Cost-effectiveness of mass screening and targeted biphosphonates treatment in osteoporosis

in Osteoporosis International (2008, April), 19(S1), 117

Efficiency and recommendations for osteoporosis screening strategy

in Osteoporosis International (2008, April), 19(S1), 116

Changes in femoral neck bone mineral density are associated with hip fracture incidence in untreated postmenopausal women

in Osteoporosis International (2008, April), 19(Suppl.1), 18-19