Journal of comparative effectiveness research最新文献

{"title":"Comparison of deep prostate-specific antigen response in Black patients with metastatic castration-sensitive prostate cancer initiated on apalutamide or enzalutamide.","authors":"Benjamin H Lowentritt, Sabree Burbage, Ibrahim Khilfeh, Dominic Pilon, Shawn Du, Carmine Rossi, Frederic Kinkead, Lilian Diaz, Gordon Brown","doi":"10.57264/cer-2025-0161","DOIUrl":"10.57264/cer-2025-0161","url":null,"abstract":"<p><p><b>Aim:</b> There is limited real-world evidence about prostate-specific antigen (PSA) response to androgen receptor pathway inhibitor treatment in Black patients with metastatic castration-sensitive prostate cancer (mCSPC). This study compared PSA90 (≥90% reduction from baseline PSA level) between apalutamide and enzalutamide among Black patients with mCSPC. <b>Materials & methods:</b> Electronic medical record data (Precision Point Specialty Analytics) were linked to claims data (Komodo Research Database) and used to select cohorts of Black patients with mCSPC treated with either apalutamide or enzalutamide. Inverse probability of treatment weighting was used to balance treatment cohorts. PSA90 response was assessed using weighted Kaplan-Meier curves and hazard ratios with 95% CIs. <b>Results:</b> The study included 451 patients (apalutamide: 230, enzalutamide: 221) with balanced baseline characteristics after inverse probability of treatment weighting. Patients treated with apalutamide had a 42% higher rate of PSA90 response within 6 months post-index compared with those treated with enzalutamide (hazard ratio: 1.42, 95% CI: 1.06, 1.91; p = 0.020). Median time to first PSA90 response was shorter among patients treated with apalutamide (3.3 months) compared with enzalutamide (5.5 months). <b>Conclusion:</b> In Black patients with mCSPC, apalutamide led to faster and significantly deeper PSA responses than enzalutamide, suggesting potential clinical advantages in optimizing early treatment response in this population. Future research should assess PSA90 as a prognostic indicator of overall survival among Black patients.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250161"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-line tumor necrosis factor inhibitor versus abatacept treatment choice in real-world patients with anticitrullinated protein antibody- and rheumatoid factor-positive rheumatoid arthritis.","authors":"Gordon Lam, Hanke Zheng, Andrew Klink, Vardhaman Patel, Emily Bland, Laetitia N'Dri, Parisa Asgarisabet, Keith Wittstock, Cherrishe Brown-Bickerstaff, Mark Chaballa, Vadim Khaychuk, Bruce Feinberg","doi":"10.57264/cer-2025-0062","DOIUrl":"10.57264/cer-2025-0062","url":null,"abstract":"<p><p><b>Aim:</b> To compare characteristics of patients with anticitrullinated protein antibody-positive (ACPA+) and rheumatoid factor-positive (RF+) rheumatoid arthritis (RA) who initiated abatacept or a tumor necrosis factor inhibitor (TNFi) as a first-line biologic disease-modifying antirheumatic drug (bDMARD), and to identify factors associated with first-line bDMARD selection. <b>Materials & methods:</b> This retrospective cohort study abstracted data for patients with ACPA+/RF+ RA initiating abatacept or a TNFi as a first-line bDMARD between 1 January 2015 and 19 February 2020. Patient characteristics were compared using chi-square/Fisher exact tests (categorical variables) and Wilcoxon tests (continuous variables). Adjusted odds ratios (OR; 95% confidence interval [CI]) of initiating abatacept versus TNFi were estimated using 2-level logistic regression. <b>Results:</b> The analysis cohort included 301 patients who initiated abatacept and 203 patients who initiated a TNFi. Time from RA diagnosis to first-line initiation (>2 years vs <1 year; OR [95% CI] 2.9 [1.4-6.1]), high and moderate disease activity (versus low; 5.0 [1.8-13.9] and 4.2 [1.5-11.6], respectively), and conventional synthetic (cs) DMARD use within 12 months prior to initiation (versus no csDMARD use; 2.0 [1.1-3.6]) were associated with higher odds of initiating abatacept versus a TNFi (all p < 0.05). Patients with Medicare/other insurance had increased odds of initiating abatacept (versus TNFi) as age increased. Baseline ACPA >250 AU/ml was associated with lower odds of initiating abatacept over a TNFi (versus ACPA 20-250 AU/ml; 0.4 [0.2-0.8]; p < 0.01). <b>Conclusion:</b> In this real-world study, patients with ACPA+/RF+ RA were more likely to initiate abatacept over TNFi as a first-line bDMARD if they had delayed first-line bDMARD initiation, high/moderate disease activity, prior csDMARD use, or were of an older age. There is a need for better understanding of treatment selection and to account for these variables in future studies.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250062"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of therapies for patients with opioid use disorder: a systematic review and network meta-analysis.","authors":"Madhusudan Kabra, Tushar Srivastava, Raju Gautam, Janharpreet Singh, Juha Oksanen, Tim MacDonald, Kenneth Lee, Brent Boyett, Bill Santoro, Anurag Gupta, Anne De Jong-Laird, Shijie Ren","doi":"10.57264/cer-2025-0171","DOIUrl":"10.57264/cer-2025-0171","url":null,"abstract":"<p><p><b>Aim:</b> Opioid use disorder (OUD) leads to significant morbidity and mortality. While opioid agonist therapies like transmucosal buprenorphine and methadone are effective, they face challenges such as poor adherence, diversion risk and suboptimal abstinence rates, prompting the development of long-acting injectable (LAI) buprenorphine. However, comparative evidence among LAIs and versus standard treatments remains limited. The aim of this study is to provide comparative evidence among buprenorphine LAIs and versus oral opioid agonist treatments. <b>Materials & methods:</b> We conducted a systematic literature review and network meta-analysis (NMA) evaluating the effectiveness and safety of LAI buprenorphine treatments (extended-release buprenorphine [BUP-XR; monthly injection] and other BUP-LAI [weekly and monthly injection]) versus transmucosal buprenorphine, methadone and buprenorphine implants in adults with OUD. The review included randomized controlled trials (RCTs) and non-RCTs for LAIs (January 2012 and March 2025). Primary outcomes were treatment discontinuation and illicit opioid use. Secondary outcomes were safety and health-related quality of life. Data were synthesized using univariate NMAs, bivariate NMA with surrogate end point modelling. Studies with limited data and single-arm designs were incorporated by using study-level matching techniques. <b>Results:</b> Ninety-eight studies met the inclusion criteria. BUP-XR demonstrated the highest probability of achieving treatment retention and opioid abstinence across analyses. In combined evidence (RCTs and non-RCTs), BUP-XR showed significantly lower risk of illicit opioid use versus transmucosal buprenorphine (rate ratio [RR] 1.99; 95% credible interval [CrI]: 1.29-3.11) and methadone (RR: 2.66; 95% CrI: 1.40-3.56). BUP-XR showed borderline significantly lower risk of illicit opioid use versus other BUP-LAI (RR: 1.81; 95% CrI: 0.97-3.55) and buprenorphine implant (RR: 2.28; 95% CrI: 0.98-5.38). Treatment discontinuation rates were similar between OUD treatments. Safety outcomes were generally comparable across treatments. Health-related quality of life indicated better recovery among patients treated with BUP-XR. <b>Conclusion:</b> BUP-XR may enhance treatment retention and abstinence over other OUD therapies, supporting its integration into clinical pathways. The results may help guide future updates to OUD treatment guidelines and policies aimed at optimizing the use of long-acting formulations. Additional research is needed to better define the comparative effectiveness of LAIs.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250171"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-adjusted network meta-analyses provide new insights into the efficacy of treatment alternatives for metastatic castration-sensitive prostate cancer.","authors":"Neal Shore, Alicia K Morgans, Noman Paracha, Howard Thom, Edna Keeney, Philip Orishaba, David Phillippo, David Aceituno, Christopher Jd Wallis, Elaine Gallagher, Martin Boegemann","doi":"10.57264/cer-2025-0100","DOIUrl":"10.57264/cer-2025-0100","url":null,"abstract":"<p><p><b>Aim:</b> Recent network meta-analyses (NMAs) in metastatic castration-sensitive prostate cancer have not adequately addressed potential treatment effect modifiers and population imbalances, which introduces bias. Although, individual-patient data (IPD) are seldom available across all trials, recent methodological advances allow adjustments using a combination of IPD and aggregate data. <b>Materials & methods:</b> IPD from the ARASENS trial (darolutamide + docetaxel + androgen-deprivation-therapy [ADT]) and aggregate data from a systematic review were analyzed. Two methods were used to adjust for population imbalances: multilevel network meta-regression (ML-NMR) using baseline characteristics, and network meta-interpolation (NMI) using subgroup data. Relative effects were estimated for an ARASENS-like population, with sensitivity analysis in an average trial population. <b>Results:</b> Twelve studies, including ARASENS, were included. All studies reported baseline characteristics for ML-NMR. Sufficient subgroup data for NMI were available in 8/12 studies for overall survival (OS) and 5/12 studies for progression-free survival (PFS). Darolutamide + docetaxel + ADT showed significant benefit over docetaxel + ADT, ADT and standard-nonsteroidal-antiandrogen + ADT in all analyses. ML-NMR showed improved OS for darolutamide + docetaxel + ADT compared with abiraterone + docetaxel + ADT, apalutamide + ADT, enzalutamide + ADT and abiraterone + ADT. ML-NMR also showed improved PFS for darolutamide + docetaxel + ADT compared with apalutamide + ADT and enzalutamide + ADT. Using NMI, darolutamide + docetaxel + ADT demonstrated OS benefit over abiraterone + ADT and PFS benefit relative to abiraterone + ADT and apalutamide + ADT. Findings were consistent in an average population, although ML-NMR did not show significant OS benefit of darolutamide + docetaxel + ADT over apalutamide + ADT. <b>Conclusion:</b> Improved outcomes were observed with darolutamide + docetaxel + ADT compared with other therapies. By incorporating effect modifiers and addressing population imbalances, we provide clinicians with a more accurate understanding of treatment efficacy for better-informed decision-making.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250100"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect comparisons of tucatinib in combination with trastuzumab for patients with previously treated HER2-positive metastatic colorectal cancer.","authors":"Claire Watkins, Cyndy Simon, Peter Martin, Regina Leadley, Gabrielle Redhead, Edward Neuberger, Karen Bartley","doi":"10.57264/cer-2025-0017","DOIUrl":"10.57264/cer-2025-0017","url":null,"abstract":"<p><p><b>Aim:</b> In the single-arm MOUNTAINEER trial (NCT03043313) tucatinib in combination with trastuzumab showed an objective response rate (ORR) of 39.3% in patients with previously treated, HER2+ unresectable or metastatic colorectal cancer (mCRC). This study compared the efficacy of tucatinib in combination with trastuzumab with other treatment options in this population. <b>Materials & methods:</b> An unanchored, matching-adjusted indirect comparison was conducted following a systematic literature review that identified the CORRECT trial (NCT01103323), which investigated regorafenib, and the RECOURSE trial (NCT01607957), which investigated trifluridine-tipiracil, as comparators for tucatinib in combination with trastuzumab. Patient and study characteristics, overall survival (OS), progression-free survival (PFS) and ORR data were extracted and compared assuming HER2 status was not prognostic. Differences in adjusted covariates across analyses included patient age, performance status, time since metastatic diagnosis and prior lines of therapy. OS and PFS were compared using Cox proportional hazard models to generate match-adjusted hazard ratios (HRs) and 95% CI. ORR was compared via match-adjusted odds ratios and 95% CIs. As MOUNTAINEER only included patients from Europe and North America, sensitivity analyses used non-Japanese patients from CORRECT and European and US patients from RECOURSE. <b>Results:</b> In the main analysis, the estimated adjusted HR (95% CI) for tucatinib in combination with trastuzumab versus regorafenib was 0.26 (0.14-0.46) for OS and 0.32 (0.23-0.46) for PFS; versus trifluridine-tipiracil, this was 0.34 (0.22-0.51) for OS and 0.38 (0.20-0.58) for PFS. Similar results were seen for OS and PFS in sensitivity analyses. ORR also favored tucatinib in combination with trastuzumab across analyses. <b>Conclusion:</b> These data support that tucatinib in combination with trastuzumab is an effective therapy option in patients with previously treated mCRC.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250017"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access in all areas? A round-up of developments in market access and health technology assessment: part 12.","authors":"Sreeram V Ramagopalan, Annie Jullien Pannelay","doi":"10.57264/cer-2025-0208","DOIUrl":"10.57264/cer-2025-0208","url":null,"abstract":"<p><p>In this update we cover the impacts of the US Most Favored Nation pricing policy and research evaluating drug availability and affordability in China as a result of the National Reimbursement Drug List negotiation policy.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250208"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reshaping the cardiovascular continuum in the management of arterial and venous cardiovascular disease: a narrative review.","authors":"Khadija Hafidh, Melina Vega de Ceniga, Leonardo De Luca, Claudio Borghi","doi":"10.57264/cer-2025-0162","DOIUrl":"10.57264/cer-2025-0162","url":null,"abstract":"<p><p>The prevalence of cardiovascular disease (CVaD) is expected to double in the next 25 years, fueled by increasing prevalence of diabetes mellitus, obesity and hypertension. Cardiovascular-kidney-metabolic syndrome is a clinical entity requiring a holistic approach to prevention and management. Another aspect of this syndrome is chronic venous disease (CVeD), which is common in patients with CVaD. This review describes presentations at a symposium by the European Association of Preventive Cardiology (Milan, Italy; April 2025), discussing the interconnectedness of conditions on the CVaD continuum and their relationship with CVeD. Venous and arterial disease share common risk factors and pathogenic pathways, including endothelial dysfunction, increased vascular permeability, oxidative stress and inflammation. Many cardiometabolic and vascular conditions remain underdiagnosed and untreated, and the patients' level of risk is often underestimated. Examination of the legs is important to identify peripheral arterial disease and/or CVeD. The mainstays of treatment for CVeD are exercise, compression therapy, venoactive drugs and surgery. Failure to achieve and maintain treatment goals is usually the result of therapeutic inertia or poor medication adherence. A coherent approach is needed to identify and manage shared risk factors and comorbidities. Effective disease management and risk reduction require integrated care using multidisciplinary teams; evidence-based treatments, usually with combination therapy; and use of tools to maximize adherence, including digital tools and single-pill combinations to simplify treatment regimens in patients with multiple risk factors or comorbidities.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250162"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of socioeconomic crisis on cancer patient outcomes in Lebanon, 2018-2020.","authors":"Joel Ladner, Joseph Saba, Anas Nofel, Malak Ammar, Shahad Adnan, Etienne Audureau","doi":"10.57264/cer-2025-0099","DOIUrl":"10.57264/cer-2025-0099","url":null,"abstract":"<p><p><b>Aim:</b> The goal of this study was to assess the impact of economic and social crisis on access to cancer care in Lebanon. <b>Materials & methods:</b> A cancer Drug Access Program in Lebanon was launched, covering 80-90% of treatment costs. The program included three drugs for breast cancer, renal cancer, and lung cancer. A longitudinal follow-up of patients was conducted. The Multidimensional Poverty Measure (MPI) was used by year (2019 or 2021), i.e., before and after the onset of the economic crisis. <b>Results:</b> A total of 613 cancer patients were included in 50 hospitals. Mean patient age was 58.5 years (standard deviation = 12.3). The proportion of cancer types was 79.3% breast, 10.6% renal, and 7.3% lung cancer. Treatment with palbociclib (hazard ration [HR]: 1.64; 95% confidence interval [CI]: 1.53-1.76, p < 0.0004), enrollment prior to 1 January 2019 (HR: 1.24; 95% CI: 1.07-1.44, p = 0.004), treatment at a hospital with fewer than five physicians (HR: 1.11; 95% CI: 1.00-1.23, p = 0.04), and lower 2019 MPI (HR: 1.69; 95% CI: 1.30-2.20) were significant predictive factors associated with survival. Higher governorate-level MPI was associated with increased mortality (adjusted rate ratio per 0.1-unit, HR: 2.88; 95% CI: 0.95-8.77, p = 0.06). <b>Conclusion:</b> Economic crises have negative impacts on health outcomes, and we identified a change in survival pre/post crisis onset. This study argues strongly for coordinated efforts to mitigate the negative effects of poverty on health.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250099"},"PeriodicalIF":2.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health outcomes and costs in patients prescribed anticholinergic medications for overactive bladder.","authors":"Holly E Richter, Benjamin Chastek, Adam Carrera, Christina Steiger, Daniel Snyder, Laleh Abedinzadeh, Tim Bancroft, Jeffrey Nesheim, Roger R Dmochowski, Adonis K Hijaz, Jeffrey Frankel","doi":"10.57264/cer-2025-0054","DOIUrl":"10.57264/cer-2025-0054","url":null,"abstract":"<p><p><b>Aim:</b> Anticholinergic burden (ACB) is associated with profound clinical and economic burden; however, anticholinergic medications are often prescribed for overactive bladder (OAB). This analysis assessed risk of adverse health outcomes and costs associated with ACB among patients with OAB. <b>Materials & methods:</b> Adults with ≥1 pharmacy claim for ≥1 OAB anticholinergic medication and continuous coverage for ≥6 months before and after the first prescription fill date for OAB anticholinergic medication (index) from January 2010 to November 2021 in the Optum Research Database were included. Daily ACB scores were calculated postindex. The impact of ACB on risk of certain adverse health outcomes was examined using Cox proportional hazards regression with categorical and piecewise linear specifications for ACB. Time-varying total ACB association with healthcare costs was evaluated with marginal structural models. <b>Results:</b> Overall, 428,142 patients were included in the analysis; mean (SD) age was 65.2 (14.9) years. Mean (SD) preindex ACB was 0.53 (1.44) points/day. Postindex, OAB medications accounted for 61.0% (95% CI: 60.9%-61.1%) of total ACB. Adjusted hazard ratios for urinary tract infection (UTI), urinary retention, delirium/drowsiness, cognitive impairment, falls/fractures and cardiovascular events were >1 (vs 0 points/day) and increased with ACB. A 1-point/day increase in ACB was associated with increased risk of UTI, urinary retention, delirium/drowsiness, cognitive impairment, falls/fractures and cardiovascular events for patients with ACB ≤8 points/day preindex. Increasing ACB was associated with increased all-cause total healthcare costs and costs related to cognitive impairment and falls/fractures. <b>Conclusion:</b> The association between increased ACB and greater risk of certain adverse health outcomes and costs supports the reassessment of anticholinergic medication use for patients with OAB.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250054"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness modeling of mortality risk reduction comparing two fixed-dose combination triple therapies in moderate-to-very severe chronic obstructive pulmonary disease.","authors":"Krishnali Parsekar, Shubhram Pandey, Deniz Tansey-Dwyer, Jonathan Marshall, Isabella Rustignoli, Michael Pollack, Barinder Singh, Mario Ouwens","doi":"10.57264/cer-2025-0111","DOIUrl":"10.57264/cer-2025-0111","url":null,"abstract":"<p><p><b>Aim:</b> Two fixed-dose combination triple therapies, budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) 320/14.4/10 μg and fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 μg, have been shown to reduce all-cause mortality in phase III trials. A recent matching-adjusted indirect comparison showed greater mortality reduction with BGF versus FF/UMEC/VI. However, the comparative cost-effectiveness of these treatments remains unknown. This study aimed to use a cost-effectiveness model to compare BGF with FF/UMEC/VI in patients with moderate-to-very severe chronic obstructive pulmonary disease (COPD) who are eligible for triple therapy from a UK third-party payer perspective. <b>Materials & methods:</b> A cohort-based semi-Markov model was used with the natural progression of COPD defined by four lung function levels. Input parameters included participant characteristics and clinical efficacy parameters derived from the ETHOS and KRONOS trials, the UK general population and published literature. Unit costs were obtained from the UK National Health System Schedule of Reference Costs (2021/2022), the Personal Social Services Research Unit (2022) and published literature. Outputs included an incremental cost-effectiveness ratio, costs, quality-adjusted life years and life years at time horizons of 1 and 5 years. Model inputs and assumptions were subject to deterministic and probabilistic sensitivity and scenario analyses. <b>Results:</b> At both 1- and 5-year time horizons, BGF was less costly (-£7.24 and -£23.03 per patient) and more effective (0.002 and 0.21 quality-adjusted life years per patient) versus FF/UMEC/VI, respectively. Due to a reduced mortality rate, more patients remained on BGF treatment than on FF/UMEC/VI, which induced higher treatment-related costs; however, the latter was offset by decreased end-of-life costs, as BGF avoided more deaths. <b>Conclusion:</b> BGF may improve health outcomes and reduce healthcare costs compared with FF/UMEC/VI in patients with moderate-to-very severe COPD in a UK setting.</p>","PeriodicalId":15539,"journal":{"name":"Journal of comparative effectiveness research","volume":" ","pages":"e250111"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}