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First-line immunotherapy of neuronal surface antibody-mediated autoimmune encephalitis: Assessment of therapeutic effectiveness and cost-efficiency.
Cai, Meng-Ting; Lai, Qi-Lun; Zheng, Yang; Fang, Gao-Li; Shen, Chun-Hong; Xu, Yong-Feng; Zhang, Yin-Xi; Ding, Mei-Ping.
Afiliación
  • Cai MT; Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Lai QL; Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Zheng Y; Department of Neurology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
  • Fang GL; Department of Neurology, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, China.
  • Shen CH; Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Xu YF; Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
  • Zhang YX; Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: zyx-neurology@zju.edu.cn.
  • Ding MP; Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: dmp-neurology@zju.edu.cn.
Mult Scler Relat Disord ; 66: 104071, 2022 Oct.
Article en En | MEDLINE | ID: mdl-35917744
OBJECTIVE: To evaluate the therapeutic effectiveness and cost-efficiency of first-line immunotherapies on neuronal surface antibody-mediated autoimmune encephalitis (AE) based on a real-world observational study in China. METHODS: Our study retrospectively collected the clinical and paraclinical data of patients with definite neuronal surface antibody-mediated AE between July 2014 and July 2020. Regular follow-up was performed after administering standard regimens of first-line immunotherapies, including intravenous methylprednisolone (IVMP) and / or intravenous immunoglobulin (IVIG). Therapeutic effectiveness was reflected by modified Rankin Scale scores. The health resource utilization and direct medical costs were extracted to analyze the cost-efficiency. RESULTS: Among the 78 eligible patients, 48 (61.5%) were males with a median age of 40 years. More than half (56, 71.8%) were treated with combination therapy, with the rest receiving IVMP and IVIG monotherapy (both of 11, 14.1%). Related objective variables, i.e., sex, onset age, disease course, onset symptoms, antibody types, abnormal paraclinical results, disease severity, and the health insurance, showed insignificant differences on the selection of therapy. Each therapy showed similar short-term (4-week) and long-term (1-year) therapeutic effects. Yet the single or combination of IVIG had a slightly better effectiveness but higher cost than the monotherapy of IVMP. CONCLUSION: The combination of IVMP and IVIG was used more frequently than either alone, which may be associated with neurologist's personal experience and patient's wishes. Though with similar therapeutic effectiveness, the use of IVMP alone might be a better choice with a better cost-efficiency.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inmunoglobulinas Intravenosas / Encefalitis Tipo de estudio: Health_economic_evaluation / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: Mult Scler Relat Disord Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inmunoglobulinas Intravenosas / Encefalitis Tipo de estudio: Health_economic_evaluation / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: Mult Scler Relat Disord Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos