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  1. The cost-effectiveness of liver biopsy in rheumatoid arthritis patients treated with methotrexate.

    Article - En anglais

    Objective

    To assess the cost-effectiveness of liver biopsy in monitoring rheumatoid arthritis (RA) patients for methotrexate (MTX) - induced cirrhosis.

    Methods

    A decision analytic model was used to compare a strategy of no biopsy versus strategies of biopsy after 5 years or 10 years of MTX treatment.

    Results

    Biopsy after 5 years of MTX treatment had a cost-effectiveness ratio of $1,891,830 per year of life saved, while biopsy after 10 years of treatment had a cost-effectiveness ratio of $52,374 per year of life saved.

    Sensitivity analyses revealed that the cost-effectiveness of biopsy was most dependent on the probability of cirrhosis.

    Conclusion

    Liver biopsy to monitor for MTX-induced cirrhosis in RA patients is not cost effective after 5 years of treatment, and even biopsy after 10 years has a high cost.

    Mots-clés Pascal : Etats Unis, Economie santé, Analyse coût efficacité, Toxicité, Foie, Cirrhose, Immunomodulateur, Antirhumatismal, Méthotrexate, Homme, Chimiothérapie, Polyarthrite rhumatoïde, Antiinflammatoire, Biopsie, Surveillance, Evaluation, Modèle, Chronique, Amérique du Nord, Amérique, Appareil digestif pathologie, Foie pathologie, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune

    Mots-clés Pascal anglais : United States, Health economy, Cost efficiency analysis, Toxicity, Liver, Cirrhosis, Immunomodulator, Antirheumatic agent, Human, Chemotherapy, Rheumatoid arthritis, Antiinflammatory agent, Biopsy, Surveillance, Evaluation, Models, Chronic, North America, America, Digestive diseases, Hepatic disease, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0287753

    Code Inist : 002B30A01C. Création : 01/03/1996.