Direct and indirect costs associated with Dupuytren’s contracture

Macaulay, Dendy; Ivanova, Jasmina; Birnbaum, Howard G.; Sorg, Rachael; Skodny, Paul

doi:10.3111/13696998.2012.670678

Cited by 18 publications

(18 citation statements)

References 20 publications

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“…We hypothesize that the trend is a reflection of the aging population because the prevalence and severity of DD increases with age [ 37 ]. Moreover, the incidence of DD increases with comorbidities like diabetes mellitus [ 9 , 31 ], hyperlipidemia [ 38 , 39 ], and hypertension [ 23 , 40 ], all of which are highly prevalent in the elderly [ 41 - 44 ]. Furthermore, the universal coverage and low copayment of Taiwan’s NHI system has increased the affordability of healthcare here, which increases the diagnostic rate for DD.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological profile of Dupuytren’s disease in Taiwan (Ethnic Chinese): a nationwide population-based study

Yeh

Huang

et al. 2015

BMC Musculoskelet Disord

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BackgroundThe epidemiologic profile of ethnic Chinese patients with Dupuytren’s disease is unknown. We therefore investigated the epidemiology of Dupuytren’s disease using Taiwan’s National Health Insurance Research Database.MethodsPatients who filed claims for treatment for Dupuytren’s disease between January 2000 and December 2011 were identified in the database. Age- and gender-specific incidences were estimated by dividing the incidence number by population data.ResultsWe identified 1,078 patients with Dupuytren’s disease (681 men, 397 women; male/female ratio: 1:1.72). The annual incidence rate ranged from 0.39-0.63/105 for men and 0.14-0.44/105 for women. A trend analysis revealed a rising trend in the annual incidence from 2001 to 2011 (p = 0.0199). The prevalence rate increased steadily from 0.46/105 in 2000 to 4.52/105 in 2011 (p = 0.0186). The mean age at onset was significantly higher in men than in women (60.7 ± 18.4 vs. 53.7 ± 15.5 years). Peak age at onset for men was 70–79 (28.1%) and for women was 50–59 (33.5%). Men > 60 years old had higher incidence rates than did women (incidence rate ratios: 2.0, 4.5, and 6.6 for those 60–69, 70–79, and ≥ 80, respectively). Hypertension (29.6%), diabetes mellitus (21.9%), hyperlipidemia (14.8%), ischemic heart disease (10.5%), and chronic obstructive pulmonary disease (8.0%) were the most common comorbidities.ConclusionsThe incidence and prevalence of Dupuytren’s disease and the male/female ratio were significantly lower in ethnic Chinese than in Western ethnic groups. Moreover, the age at onset was significantly lower in ethnic Chinese women. However, the incidences of three comorbidities (hypertension, diabetes mellitus, and hyperlipidemia) were similar to those in other ethnicities.

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Section: Discussionmentioning

confidence: 99%

Epidemiological profile of Dupuytren’s disease in Taiwan (Ethnic Chinese): a nationwide population-based study

Yeh

Huang

et al. 2015

BMC Musculoskelet Disord

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“…The prevalence rate in the United States is reported to be >7 % [10]. In the USA, disability and treatments for DD account for significant losses to the economy and substantial direct and indirect costs [11]. At present there is no cure for DD.…”

Section: Introductionmentioning

confidence: 99%

Anti-fibrotic action of pirfenidone in Dupuytren’s disease-derived fibroblasts

Zhou

Liu

Gallo

et al. 2016

BMC Musculoskelet Disord

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BackgroundDupuytren’s disease (DD) is a complex fibro-proliferative disorder of the hand that is often progressive and eventually can cause contractures of the affected fingers. Transforming growth factor beta (TGF-β1) has been implicated as a key stimulator of myofibroblast activity and fascial contraction in DD. Pirfenidone (PFD) is an active small molecule shown to inhibit TGF-β1-mediated action in other fibrotic disorders. This study investigates the efficacy of PFD in vitro in inhibiting TGF-β1-mediated cellular functions leading to Dupuytren’s fibrosis.MethodsFibroblasts harvested from (DD) and carpal tunnel (CT)- tissues were treated with or without TGF-β1 and/or PFD and were subjected to cell migration, cell proliferation and cell contraction assays. ELISA; western blots and real time RT-PCR assays were performed to determine the levels of fibronectin; p-Smad2/Smad3; alpha-smooth muscle actin (α-SMA), α2 chain of type I collagen and α1 chain of type III collagen respectively.ResultsOur results show that PFD effectively inhibits TGF-β1-induced cell migration, proliferation and cell contractile properties of both CT- and DD-derived fibroblasts. TGF-β1−induced α-SMA mRNA and protein levels were inhibited at the higher concentration of PFD (800 μg/ml). Interestingly, TGF-β1 induction of type I and type III collagens and fibronectin was inhibited by PFD in both CT- and DD- derived fibroblasts, but the effect was more prominent in DD cells. PFD down-regulated TGF-β1-induced phosphorylation of Smad2/Smad3, a key factor in the TGF-β1 signaling pathway.ConclusionTaken together these results suggest the PFD can potentially prevent TGF-β1−induced fibroblast to myofibroblast transformation and inhibit ECM production mainly Type I- and Type III- collagen and fibronectin in DD-derived fibroblasts. Further in-vivo studies with PFD may lead to a novel therapeutic application in preventing the progression or recurrence of Dupuytren’s disease.

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“…Previous studies have assessed the burden of DC in terms of impaired health-related quality of life (HRQoL) and direct and indirect costs (Desai and Hentz 2010, Macaulay et al 2012). Evaluation of different treatments for DC requires information on their relative HRQoL and eco- nomic benefits.…”

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confidence: 99%

Eliciting health state utilities for Dupuytren’s contracture using a discrete choice experiment

Gu¹,

Botteman²,

Gerber³

et al. 2013

Acta Orthopaedica

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Background and purposeAn internet-based discrete choice experiment (DCE) was conducted to elicit preferences for a wide range of Dupuytren’s contracture (DC)-related health states. An algorithm was subsequently developed to convert these preferences into health state utilities that can be used to assess DC’s impact on quality of life and the value of its treatments.MethodsHealth state preferences for varying levels of DC hand severity were elicited via an internet survey from a sample of the UK adult population. Severity levels were defined using a combination of contractures (0, 45, or 90 degrees) in 8 proximal interphalangeal and metacarpophalangeal joints of the index, middle, ring, and little fingers. Right-handed, left-handed, and ambidextrous respondents indicated which hand was preferable in each of the 10 randomly-selected hand-pairings comparing different DC severity levels. For consistency across comparisons, anatomically precise digital hand drawings were used. To anchor preferences onto the traditional 0–1 utility scale used in health economic evaluations, unaffected hands were assigned a utility of 1.0 whereas the utility for a maximally affected hand (i.e., all 8 joints set at 90 degrees of contracture) was derived by asking respondents to indicate what combination of attributes and levels of the EQ-5D-5L profile most accurately reflects the impact of living with such hand. Conditional logistic models were used to estimate indirect utilities, then rescaled to the anchor points on the EQ-5D-5L.ResultsEstimated utilities based on the responses of 1,745 qualified respondents were 0.49, 0.57, and 0.63 for completely affected dominant hands, non-dominant hands, or ambidextrous hands, respectively. Utility for a dominant hand with 90-degree contracture in t h e metacarpophalangeal joints of the ring and little fingers was estimated to be 0.89. Separately, reducing the contracture of metacarpophalangeal joint for a little finger from 50 to 12 degrees would improve utility by 0.02.InterpretationDC is associated with substantial utility decre- ments. The algorithms presented herein provide a robust and flexible framework to assess utility for varying degrees of DC severity.

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Direct and indirect costs associated with Dupuytren’s contracture

Abstract: Employees with DC had substantially higher comorbidity rates, utilization, and direct and indirect costs compared with demographically matched controls.

Cited by 18 publications

References 20 publications

Epidemiological profile of Dupuytren’s disease in Taiwan (Ethnic Chinese): a nationwide population-based study

Epidemiological profile of Dupuytren’s disease in Taiwan (Ethnic Chinese): a nationwide population-based study

Anti-fibrotic action of pirfenidone in Dupuytren’s disease-derived fibroblasts

Eliciting health state utilities for Dupuytren’s contracture using a discrete choice experiment

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