Fagnani F, Bouvenot G, Valat J P, Bardin T, Berdah L, Lafuma A, Bono I, Eschwege E, Dreiser R L
CEMKA, Bourg la Reine, France.
Pharmacoeconomics. 1998 Jan;13(1 Pt 2):135-46. doi: 10.2165/00019053-199813010-00013.
This 9-month pragmatic study compared 2 therapeutic regimens in the management of osteoarthritis of the hip and knee. Patients received either diacerein 100 mg/day plus standard osteoarthritic therapy for 6 months, followed by a 3-month monitoring period without diacerein, or standard therapy alone for the entire 9-month period. A total of 207 patients with osteoarthritis of the knee and hip were enrolled. Improvements in Lequense's functional index and quality-of-life scores (revised Arthritis Impact Measurement Scales Health Status Questionnaire and Nottingham Health Profile), and decreases in nonsteroidal anti-inflammatory drug and analgesic consumption were significantly greater with diacerein plus standard therapy than with standard therapy alone. The overall assessment of therapy by patients was good or excellent for 60% of those who received diacerein plus standard therapy, compared with 26% who received standard therapy alone. Medical and paramedical procedures carried out in addition to those stipulated in the protocol (medical consultations, physiotherapy, nursing, etc.), osteoarthritis-related, were fewer and less costly in the diacerein plus standard therapy group than in the standard therapy group. The average outpatient cost (in 1995 French francs) of osteoarthritis treatment in the standard therapy group was FF2272 compared with FF2360 in the diacerein plus standard therapy group. The cost-effectiveness ratios per point scored on Lequesne's index were FF1893 for the standard therapy group and FF1072 for the diacerein plus standard therapy group, leading to a saving of 43% with diacerein plus standard therapy. The marginal cost (additional cost corresponding to the clinical benefit obtained by adding diacerein to standard treatment) was FF88 per point scored on Lequesne's index.
这项为期9个月的实用性研究比较了2种治疗方案用于髋部和膝部骨关节炎的治疗效果。患者要么接受每天100毫克双醋瑞因加标准骨关节炎治疗6个月，随后是3个月不使用双醋瑞因的监测期，要么在整个9个月期间仅接受标准治疗。共有207例髋部和膝部骨关节炎患者入组。与单纯标准治疗相比，双醋瑞因加标准治疗在改善勒昆斯功能指数和生活质量评分（修订的关节炎影响测量量表健康状况问卷和诺丁汉健康概况）以及减少非甾体抗炎药和镇痛药用量方面效果显著更佳。接受双醋瑞因加标准治疗的患者中60%对治疗的总体评价为良好或优秀，而接受单纯标准治疗的患者这一比例为26%。除方案规定的医疗程序（医学咨询、物理治疗、护理等）外，与骨关节炎相关的额外医疗和辅助医疗程序在双醋瑞因加标准治疗组比在标准治疗组更少且成本更低。标准治疗组骨关节炎治疗的平均门诊费用（以1995年法国法郎计）为2272法郎，而双醋瑞因加标准治疗组为2360法郎。标准治疗组每提高1分勒昆斯指数的成本效益比为1893法郎，双醋瑞因加标准治疗组为1072法郎，这表明双醋瑞因加标准治疗可节省43%的成本。边际成本（在标准治疗基础上加用双醋瑞因所获得的临床益处对应的额外成本）为每提高1分勒昆斯指数88法郎。
