Hospital Universitario La Fe, Servicio de Hematologia, Valencia, Spain.
Value Health. 2011 Jan;14(1):90-6. doi: 10.1016/j.jval.2010.10.017.
Utility-based measures of quality of life are recommended by some decision makers in health care. No studies have addressed changes in utility in patients with chronic idiopathic thrombocytopenia (ITP). This study sought to assess the health utilities of patients with chronic ITP and to evaluate the association of change in health utility with changes in other variables, including platelet response status and bleeding events.
We analyzed EQ-5D data from two international, randomized, placebo-controlled, double-blind, 24-week trials that evaluated the efficacy and safety of romiplostim in adult patients with chronic ITP.
A total of 125 subjects participated. Mean change, adjusted for age, gender, splenectomy status, and baseline score using multiple linear regression models was greater for romiplostim versus placebo for the EQ-5D index score (0.05 vs. -0.03, P = 0.015) and the VAS score (6.42 vs. 0.48, P = 0.066); similar for durable platelet responders versus nonresponders; and greater for EQ-5D index scores for subjects who did not have a bleeding event during the study (n = 29) compared to subjects who did have a bleeding event (n = 47) (0.06 vs. 0.005; P = 0.066).
Using romiplostim in cases of chronic ITP was associated with improvement in health-related quality of life as measured by the EQ-5D index score. Health utility scores derived using the EQ-5D in this study may be useful for determining quality-adjusted life years (QALYs) in economic evaluations of romiplostim for treatment of chronic ITP.
一些医疗保健决策者推荐使用基于效用的生活质量衡量标准。目前尚无研究探讨慢性特发性血小板减少性紫癜(ITP)患者的效用变化。本研究旨在评估慢性 ITP 患者的健康效用,并评估健康效用变化与其他变量变化(包括血小板反应状态和出血事件)之间的关联。
我们分析了两项评估罗米司亭治疗成人慢性 ITP 的疗效和安全性的国际、随机、安慰剂对照、双盲、24 周试验的 EQ-5D 数据。
共有 125 名受试者参与。使用多元线性回归模型,根据年龄、性别、脾切除术状态和基线评分调整后,罗米司亭组的 EQ-5D 指数评分(0.05 比-0.03,P = 0.015)和 VAS 评分(6.42 比 0.48,P = 0.066)较安慰剂组均有改善;在持久性血小板反应者和非反应者之间相似;在研究期间无出血事件的受试者(n = 29)的 EQ-5D 指数评分较有出血事件的受试者(n = 47)更高(0.06 比 0.005;P = 0.066)。
在慢性 ITP 中使用罗米司亭与健康相关生活质量的改善有关,这可通过 EQ-5D 指数评分来衡量。本研究中使用 EQ-5D 得出的健康效用评分可能有助于确定罗米司亭治疗慢性 ITP 的经济评估中的质量调整生命年(QALYs)。