Evidence map›Paper›PMID 19855441›Full record

ArticleBone marrow transplantation2010

Autologous haematopoietic stem cell transplantation for secondary progressive multiple sclerosis: an exploratory cost-effectiveness analysis.

P Tappenden, R Saccardi, C Confavreux, B Sharrack, P A Muraro, G L Mancardi, T Kozak, D Farge-Bancel, J Madan, R Rafia and 2 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Bone marrow transplantation, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Cost and effectiveness of autologous haematopoietic stem cell transplantation and high-efficacy disease-modifying therapies in relapsing-remitting multiple sclerosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Article
  4. Review
  5. Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Review
  13. Review
  14. Review
  15. Feasibility of cell therapy in multiple sclerosis: a systematic review of 83 studies.International journal of hematology-oncology and stem cell research · 2013
    Review
  16. Hematopoietic stem cell therapy for multiple sclerosis: top 10 lessons learned.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2013
    Review
  17. Transplantation for autoimmune diseases in north and South America: a report of the Center for International Blood and Marrow Transplant Research.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2012
    Article
  18. Article
  19. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 5 countries.

P TappendenHealth Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK. p.tappenden@sheffield.ac.uk
R Saccardi
C Confavreux
B Sharrack
P A Muraro
G L Mancardi
T Kozak
D Farge-Bancel
J Madan
R Rafia
R Akehurst
J Snowden
University of Sheffield · GBSheffield Teaching Hospitals NHS Foundation Trust · GBAzienda Ospedaliero-Universitaria Careggi · ITCharles University · CZHôpital Pierre Wertheimer · FRImperial College London · GBTechnology Service Corporation (United States) · USUniversity of Genoa · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Treatment options for secondary progressive multiple sclerosis (SPMS) are limited. Mitoxantrone is routinely used to stabilize disease progression; however, evolving evidence suggests clinical benefit from intensive treatment with autologous haematopoietic stem cell transplantation (HSCT). Given differences in cost and outcomes, preliminary cost-effectiveness studies are warranted if this approach is to be developed for more widespread application in SPMS. We developed a decision-analytic Markov model to explore the potential cost-effectiveness of autologous HSCT versus mitoxantrone in SPMS, using patient-level data from registry sources. The model evaluates the lifetime costs and health outcomes associated with disability progression and relapse. Sensitivity analyses were undertaken to examine the uncertainty surrounding cost-effectiveness outcomes. In the absence of randomised controlled trial (RCT) evidence, conditions for comparative analysis were not ideal. Under optimistic assumptions, HSCT is estimated to cost below pound3000 per quality adjusted life year gained. However, when a strict 6-month sustained progression rule is adopted, HSCT may be less effective and more expensive than mitoxantrone. The model results were sensitive to reducing procedural costs and HSCT-related mortality. We conclude that HSCT could potentially achieve an acceptable level of cost-effectiveness. However, caution should be exercised as large, high-quality RCTs comparing HSCT versus mitoxantrone are necessary to validate these findings.

Indexed as

AdolescentAdultCost-Benefit AnalysisFemaleHematopoietic Stem Cell TransplantationHumansMaleMarkov ChainsMiddle AgedMitoxantroneMultiple Sclerosis, Chronic ProgressiveQuality-Adjusted Life YearsRegistriesRetrospective StudiesTransplantation, AutologousTreatment OutcomeMitoxantrone

Identifiers

PMID19855441
OpenAlexW2000775134

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.