Genicular artery embolization for knee osteoarthritis: a systematic review with meta-analysis and cost-analysis

IF 1.5 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Aránzazu Hernández-Yumar , Yadira González-Hernández , Tasmania del Pino-Sedeño , Cristina Valcárcel-Nazco , Aythami de Armas-Castellano , Estefanía Herrera-Ramos , Julián Portero Navarro , Montserrat Carmona-Rodríguez , María Ximena Rojas-Reyes , María M. Trujillo-Martín
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引用次数: 0

Abstract

Objective

To assess the effectiveness, safety, and cost-effectiveness of genicular artery embolization (GAE) for the treatment of mild or moderate knee osteoarthritis (KO) refractory to standard treatment, and/or severe KO in individuals not eligible for surgery.

Method

We conducted a systematic review with meta-analysis, supplemented by a cost-analysis, comparing GAE and standard treatment, from the perspective of the Spanish National Health System (NHS) over a one-year time horizon. The health improvement required for GAE to be deemed cost-effective was quantified, considering a willingness-to-pay threshold of 25 000 €/quality-adjusted life year (QALY).

Results

We included two randomized controlled trials in our analysis. Pain estimates showed inconsistent results, and no significant effects were observed for overall function, health-related quality of life, or changes in the need for pain management medication. No serious complications or major adverse events were observed. GRADE quality of evidence ranged from moderate to low. No economic evaluations were identified. Our cost-analysis revealed that GAE would result in an incremental cost of € 3432.37 per patient, requiring a health improvement of 0.137 QALY per patient to be deemed a cost-effective technology.

Conclusions

In summary, based on moderate to low-certainty evidence, it remains inconclusive whether there is any difference between GAE and standard treatment for KO. However, the use of GAE would increase the costs. Larger randomized controlled trials are needed to determine the effects of using GAE for chronic pain secondary to KO and, consequently, to ascertain whether this technology could potentially become cost-effective from the NHS perspective.
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来源期刊
Gaceta Sanitaria
Gaceta Sanitaria 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.10
自引率
5.30%
发文量
80
审稿时长
29 days
期刊介绍: Gaceta Sanitaria (Health Gazette) is an international journal that accepts articles in Spanish and in English. It is the official scientific journal of the Sociedad Española de Salud Publica y Administración Sanitaria (Spanish Society of Public Health and Health Administration) (SESPAS). The Journal publishes 6 issues per year on different areas of Public Health and Health Administration, including: -Applied epidemiology- Health prevention and promotion- Environmental health- International health- Management and assessment of policies and services- Health technology assessments- Health economics. The editorial process is regulated by a peer review system. It publishes original works, reviews, opinion articles, field and methodology notes, protocols, letters to the editor, editorials, and debates.
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