Cost-effectiveness of TLC-sucrose octasulfate versus control dressings in the treatment of diabetic foot ulcers

Lobmann, Ralf; Augustin, Matthias; Lawall, Holger; Tigges, Wolfgang; Potempa, Christoph; Thiem, Helena; Fietz, Cornelia; Rychlik, Reinhard

doi:10.12968/jowc.2019.28.12.808

Cited by 24 publications

(22 citation statements)

References 23 publications

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“…Study setting and cohort. Study settings were diverse and accounted for South America, [41,55] Australia, [42] Canada, [43] China, [59] Europe [47,49,[51][52][53][54]56] and North America [44-46, 48, 50, 57, 58] (Table 2). Patients across all age groups 18 years and over were captured.…”

Section: Economic Evaluation Characteristicsmentioning

confidence: 99%

“…The economic perspective taken by each study determines the cost and benefits included. [17] The societal perspective was taken by Cárdenas et al [41] and Redekop et al [54] The perspective of the healthcare system was taken in six studies [42,43,50,55,57,59] and the payers perspective was taken in five [45,46,49,56,58] (Table 2). Both the societal and payers perspectives were taken by Guo et al [48] Perspective was not reported in five studies, [44,47,[51][52][53] however Ortegon et al [51] discussed some results from the policy and clinical perspective.…”

Section: Economic Evaluation Characteristicsmentioning

confidence: 99%

“…[42,44,53,55,56,59] The longest time horizon was 12-years by Chuck et al [43] Short time horizons were taken by Gilligan et al [46] and Guest et al [47] of three and four months respectively. Two time horizons were taken in two papers, Tesar et al [56] used 5-and 10-year time horizons and Lobmann et al [49] used 20-week and 100-week time horizons. Persson et al time horizon was between one and two years.…”

Section: Economic Evaluation Characteristicsmentioning

confidence: 99%

“…Four studies did not report a discount rate. [43,44,49,57] Three studies used a 3% discount rate, however none of them justified this choice. [48,51,53] Four studies used a 5% discount.…”

Section: Economic Evaluation Characteristicsmentioning

confidence: 99%

“…[41,43,44,47,48,50,59] The Markov model was the most common choice and was used in ten studies. [42,45,46,49,[51][52][53][54][55][56] Costs included. There was variation between cost inclusions in each study depending on setting, perspective and interventions investigated.…”

Section: Plos Onementioning

confidence: 99%

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Economic evaluations considering costs and outcomes of diabetic foot ulcer infections: A systematic review

et al. 2020

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Background Diabetic foot ulcer (DFU) is a severe complication of diabetes and particularly susceptible to infection. DFU infection intervention efficacy is declining due to antimicrobial resistance and a systematic review of economic evaluations considering their economic feasibility is timely and required. Aim To obtain and critically appraise all available full economic evaluations jointly considering costs and outcomes of infected DFUs. Methods A literature search was conducted across MedLine, CINAHL, Scopus and Cochrane Database seeking evaluations published from inception to 2019 using specific key concepts. Eligibility criteria were defined to guide study selection. Articles were identified by screening of titles and abstracts, followed by a full-text review before inclusion. We identified 352 papers that report economic analysis of the costs and outcomes of interventions aimed at diabetic foot ulcer infections. Key characteristics of eligible economic evaluations were extracted, and their quality assessed against the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results 542 records were screened and 39 full-texts assessed for eligibility. A total of 19 papers were included in the final analysis. All studies except one identified cost-saving or cost-effective interventions. The evaluations included in the final analysis were so heterogeneous that comparison of them was not possible. All studies were of "excellent", "very good" or "good" quality when assessed against the CHEERS checklist.

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Section: Economic Evaluation Characteristicsmentioning

confidence: 99%

Section: Economic Evaluation Characteristicsmentioning

confidence: 99%

Section: Economic Evaluation Characteristicsmentioning

confidence: 99%

“…Four studies did not report a discount rate. [43,44,49,57] Three studies used a 3% discount rate, however none of them justified this choice. [48,51,53] Four studies used a 5% discount.…”

Section: Economic Evaluation Characteristicsmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

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Economic evaluations considering costs and outcomes of diabetic foot ulcer infections: A systematic review

et al. 2020

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Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update)

Chen,

Vilorio,

Dhatariya

et al. 2023

Diabetes Metabolism Res

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AimsPrinciples of wound management, including debridement, wound bed preparation, and newer technologies involving alternation of wound physiology to facilitate healing, are of utmost importance when attempting to heal a chronic diabetes‐related foot ulcer. However, the rising incidence and costs of diabetes‐related foot ulcer management necessitate that interventions to enhance wound healing of chronic diabetes‐related foot ulcers are supported by high‐quality evidence of efficacy and cost effectiveness when used in conjunction with established aspects of gold‐standard multidisciplinary care. This is the 2023 International Working Group on the Diabetic Foot (IWGDF) evidence‐based guideline on wound healing interventions to promote healing of foot ulcers in persons with diabetes. It serves as an update of the 2019 IWGDF guideline.Materials and MethodsWe followed the GRADE approach by devising clinical questions and important outcomes in the Patient‐Intervention‐Control‐Outcome (PICO) format, undertaking a systematic review, developing summary of judgements tables, and writing recommendations and rationale for each question. Each recommendation is based on the evidence found in the systematic review and, using the GRADE summary of judgement items, including desirable and undesirable effects, certainty of evidence, patient values, resources required, cost effectiveness, equity, feasibility, and acceptability, we formulated recommendations that were agreed by the authors and reviewed by independent experts and stakeholders.ResultsFrom the results of the systematic review and evidence‐to‐decision making process, we were able to make 29 separate recommendations. We made a number of conditional supportive recommendations for the use of interventions to improve healing of foot ulcers in people with diabetes. These include the use of sucrose octasulfate dressings, the use of negative pressure wound therapies for post‐operative wounds, the use of placental‐derived products, the use of the autologous leucocyte/platelet/fibrin patch, the use of topical oxygen therapy, and the use of hyperbaric oxygen. Although in all cases it was stressed that these should be used where best standard of care was not able to heal the wound alone and where resources were available for the interventions.ConclusionsThese wound healing recommendations should support improved outcomes for people with diabetes and ulcers of the foot, and we hope that widescale implementation will follow. However, although the certainty of much of the evidence on which to base the recommendations is improving, it remains poor overall. We encourage not more, but better quality trials including those with a health economic analysis, into this area.

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Sucrose Octasulfat – Evidenz in der Behandlung chronischer Wunden

Dissemond

Augustin

Dietlein³

et al. 2020

Hautarzt

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Zusammenfassung Bei Patienten mit chronischen Wunden sollte neben einer ursächlichen Therapie auch immer eine Wundbehandlung erfolgen. Wiederholt wurde in diesem Kontext über die unzureichende Evidenz von Wundheilungsprodukten diskutiert. An dem Beispiel von TLC(„technology lipido-colloid“)-Sucrose Octasulfat wird in der vorliegenden Übersichtsarbeit gezeigt, dass auch in diesem Bereich eine aussagekräftige Datenlage mit guter Evidenz und Vergleichbarkeit vorliegt. Ein therapeutischer Ansatzpunkt, die Wundheilung zu fördern, ist die Hemmung von Matrixmetalloproteinasen beispielsweise durch Sucrose Octasulfat. Für Wundprodukte mit TLC-Sucrose Octasulfat wurden in den letzten Jahren mehrere, aufeinander aufbauende klinische Studien durchgeführt. Die WHAT-Studie war eine offene RCT (randomisierte kontrollierte Studie) mit 117 Patienten mit Ulcus cruris venosum. Bei der CHALLENGE-Studie handelte es ich um eine doppelblind durchgeführte RCT mit 187 Patienten mit Ulcus cruris venosum. Die SPID-Studie war eine Pilotstudie mit 33 Patienten mit diabetischem Fußulkus (DFU). In 2 prospektiven, multizentrischen klinischen Pilotstudien NEREIDES und CASSIOPEE wurden insgesamt 88 Patienten mit Ulcera crurum in verschiedenen Heilungsphasen untersucht. In der REALITY-Studie erfolgte eine gepoolte Datenanalyse über 8 Anwenderbeobachtungen mit 10.220 Patienten mit chronischen Wunden unterschiedlicher Genese. In der doppelblinden, zweiarmigen EXPLORER-RCT wurden 240 Patienten mit neuroischämischem DFU erstmalig bis zur vollständigen Abheilung untersucht. In allen Studien konnte eine signifikante Förderung der Wundheilung durch den Einsatz von Wundheilungsprodukten mit TLC-Sucrose Octasulfat gezeigt werden.

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Cost-effectiveness of TLC-sucrose octasulfate versus control dressings in the treatment of diabetic foot ulcers

Cited by 24 publications

References 23 publications

Economic evaluations considering costs and outcomes of diabetic foot ulcer infections: A systematic review

Economic evaluations considering costs and outcomes of diabetic foot ulcer infections: A systematic review

Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update)

Sucrose Octasulfat – Evidenz in der Behandlung chronischer Wunden

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