Cost-minimization analysis of the direct costs of TPE and IVIg in the treatment of Guillain-Barré syndrome

Winters, Jeffrey L.; Brown, David; Hazard, Elisabeth; Chainani, Ashok; Andrzejewski, Chester

doi:10.1186/1472-6963-11-101

Cited by 70 publications

(43 citation statements)

References 34 publications

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“…Almost all the patients with this condition require hospitalization and one-third of them need to be admitted to the intensive care unit (ICU) because of respiratory failure, dysautonomia, or because of medical complications [58]. Most of the patients require therapeutic plasma exchange or intravenous immunoglobulin infusion therapy [59] and long-term disability, and change in their social status is not uncommon [60]. The mortality reported in the articles included in our review is still high (15 %).…”

Section: Discussionmentioning

confidence: 99%

Guillain–Barré syndrome in Colombia: where do we stand now?

Mahecha

Ojeda²,

Vega³

et al. 2016

Immunol Res

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Guillain-Barré syndrome (GBS) is a rapid-onset muscle weakness disease caused by the immune-mediated damage of the peripheral nervous system. Since there is an increase incidence of GBS cases in Latin America, particularly in Colombia, and most of them are currently preceded by Zika virus (ZIKV) infection, we aimed to assess the available evidence of the disease in Colombia through a systematic literature review. Out of 51 screened abstracts, only 16 corresponded to articles that met inclusion criteria, of which 15 were case reports or case series. A total of 796 cases of GBS were reported in the included articles. The majority of patients were males (66.8 %) and younger than 50 years old (94 %). An infectious disease before the onset of GBS was registered in 31 % of patients, with gastrointestinal or respiratory symptoms being the most frequently observed. In those cases in which electrodiagnostic tests were performed, the most common subphenotype was acute inflammatory demyelinating polyneuropathy (17 %). Death was reported in 15 % of patients. Data regarding GBS in Colombia is scant and heterogeneous. Taking into account the burden of the disease and the recent rise of GBS cases associated with ZIKV, a careful patient evaluation and a systematic collection of data are warranted. A form to data gathering is proposed.

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Section: Discussionmentioning

confidence: 99%

Guillain–Barré syndrome in Colombia: where do we stand now?

Mahecha

Ojeda²,

Vega³

et al. 2016

Immunol Res

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“…As for cost In GBS patients, direct costs of IVIG therapy was found to be more than twice that of plasma exchange. Given equivalent efficacy and similar severity and frequencies of adverse events, plasmapaharesis if feasible is preferred 12 . However plasmapaharesis execution was often hindered by availability of filters and or small patient size.…”

Section: Discussionmentioning

confidence: 99%

Pattern of intravenous immunoglobulins (IVIG) use in a pediatric intensive care facility in a resource limited setting

Galal¹

2013

Afr H. Sci.

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Background: Intravenous Immunoglobulin (IVIG) preparations are scarce biological products used for replacement or immunomodulatory effects. Guidelines have been issued by regulatory health authorities to ensure provision of the products for patients who are in severe need. Objectives: The study aimed at description of the pattern of IVIG use (label/off label indications), adverse effects observed, reason for choice of IVIG among other modalities and efficacy in a pediatric intensive care setting. Methods: A retrospective chart review. Patients: The study included 45 cases admitted from 2008 through 2011 in a Pediatric Intensive Care Unit (PICU) of a tertiary referral pediatric hospital. Results: The clinical diagnoses included neurology (35%), neonatology (16%), hematology (11%), autoimmune disorders (11%) immunodeficiency disorders (11%), infections other than neonatal sepsis (9%) and cardiology (6.5 %). The indications for IVIG use had an Evidence category Ia / Ib in 62 % of cases whereas the other 38 % had level II and III evidence. Choice of IVIG as a therapeutic option was based on failure of other treatment options to achieve response in 46.5%, lack of alternative treatment options 15.5 % and the need for urgent response in 38 %. Adverse events, duration and doses are reported. Conclusion: IVIG use is governed by availability of alternative options and the need for urgent response in critically ill children. Guidelines should be issued based on locally available treatment options and their cost effectiveness.

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“…İskoçya ve Amerika Birleşik Devletleri'nde yapılan ve 5 seans PD ile 5 günlük İVİG tedavisinin karşılaştırıldığı maliyet verimliliği çalışmalarında PD tedavisinin İVİG tedavisine göre yarı yarıya daha az maliyetli olduğu ve benzer etkinlikleri nedeniyle öncelikle tercih edilebileceği bildirilmektedir. 23,24 Bununla birlikte bu çalışmalar erişkin yaş grubunda yapılmıştır. Çocuk yaş grubunda plazma değişim işlemi teknik olarak (plazma değişim setleri) erişkinlere benzer maliyette olup albümin ve İVİG maliyeti ise hasta yaşı küçüldükçe azalacaktır.…”

Section: Discussionunclassified

Retrospective Analysis of Cases with Guillain-Barré Syndrome in Pediatric Intensive Care Unit

Kıhtır¹,

Ankay²,

Şevketoğlu³

et al. 2017

cayd

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Amaç: Çalışmamızda Guillain-Barré sendromu nedeniyle çocuk yoğun bakımı ünitesinde takip edilmiş olan olguların tedavi yaklaşımları ve tedaviye yanıtlarının karşılaştırılarak tartışılması amaçlanmıştır. Yöntemler: Çocuk yoğun bakım kliniğinde 01.01.2006 -01.01.2016 yılları arasında Guillain-Barré sendromu tanısıyla takip ve tedavi edilen 1 ay -18 yaş arası olgular geriye dönük olarak incelendi. Bulgular: Çalışmaya 27 (10 kız %37) olgu dahil edildi. Ortanca yaş 6,24 yıl (IQR: 4,07-10,03) olarak tespit edildi. Başvuru Hughes skorlamasında 9 (%33,3) olgu üçüncü düzey, 16 (%59,3) olgu dördüncü düzey ve 2 (%7,4) olgunun da beşinci düzey olduğu tespit edildi. Olguların 22'sine (%81,4) elektrofizyolojik çalışma yapıldığı ve 10 (%45,5) olguya akut enflamatuvar demiyelinizan poliradikülonöropati, 9 (%40,9) olguya akut motor aksonal nöropati, 1 (%4,5) olguya akut motor sensoriyel nöropati tanısı konulduğu 2 (%9,1) olgu ise normal olarak değerlendirildi. Olguların tamamının damar içi immünglobulin (İVİG) tedavisi aldığı bununla birlikte 12 (%52,17) olguya İVİG öncesinde ortanca 8 seans (5-9) plazma değişimi tedavisinin de uygulandığı tespit edildi. Olguların 6'sında (%22,2) mekanik ventilasyon gereksinimi olduğu ve ortanca 24 gün (5-41) mekanik ventilasyon uygulandığı tespit edildi. Olguların ilk destekli oturma süresi 6 (3-10) gün ilk yardımla yürüme süreleri ise 9 (7-15) gün olarak tespit edildi. Sonuç: Son yıllarda çocuklarda plazma değişiminin daha başarılı olabileceğini bildiren çalışmalar olsa da genel kabul gören yaklaşım İVİG ve plazma değişimi tedavilerinin benzer etkinlikle olduğudur. Ülkemiz şartlarında deneyimli merkezlerde yoğun bakım takibi gerektiren olgularda her iki tedavi seçeneğinin de güvenle uygulanabileceği kanaatindeyiz. Anahtar Kelimeler: Guillain-Barré sendromu, plazma değişimi, damar içi immünglobulinler, çocuk yoğun bakım ünitesi

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Cost-minimization analysis of the direct costs of TPE and IVIg in the treatment of Guillain-Barré syndrome

Cited by 70 publications

References 34 publications

Guillain–Barré syndrome in Colombia: where do we stand now?

Guillain–Barré syndrome in Colombia: where do we stand now?

Pattern of intravenous immunoglobulins (IVIG) use in a pediatric intensive care facility in a resource limited setting

Retrospective Analysis of Cases with Guillain-Barré Syndrome in Pediatric Intensive Care Unit

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