Evidence map›Paper›PMID 28839824›Full record

ArticleFrontline gastroenterology2015

Low dose thiopurine and allopurinol co-therapy results in significant cost savings at a district general hospital.

Suranga Dharmasiri, Hannah Dewhurst, Heather Johnson, Sean Weaver, Simon McLaughlin

Open access · bronzeAbstract read
In one paragraph

Article in Frontline gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 34% 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

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. 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

5 authors at 2 institutions in 1 country.

Suranga DharmasiriDepartment of Gastroenterology, The Royal Bournemouth Hospital, Bournemouth, UK.
Hannah DewhurstDepartment of Gastroenterology, The Royal Bournemouth Hospital, Bournemouth, UK.
Heather JohnsonDepartment of Gastroenterology, The Royal Bournemouth Hospital, Bournemouth, UK.
Sean WeaverDepartment of Gastroenterology, The Royal Bournemouth Hospital, Bournemouth, UK.
Simon McLaughlinDepartment of Gastroenterology, The Royal Bournemouth Hospital, Bournemouth, UK.
Royal Bournemouth Hospital · GBBournemouth University · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThiopurines are widely used for maintenance of remission in Crohn's disease (CD). Published data report >50% of patients stop thiopurines due to therapeutic failure, hepatitis or side effects. In this situation, many UK clinicians start biologics in CD patients. This has significant cost implications. An alternative strategy is low dose thiopurine and allopurinol (LDTA) co-therapy. We report the annual cost savings from adopting this strategy at our centre.

methodsPatients with CD treated with LDTA in preference to biological therapy were identified using a prospective local inflammatory bowel disease database. The annual drug cost of treatment with LDTA compared with biologic therapy was calculated. Cost of attending the day unit for an infusion was not included.

results26 patients with CD who failed standard dose thiopurine and were treated with LDTA were identified over a 12-month period and followed up for 1 year. 12 patients failed LDTA and progressed to biological therapy. The remaining 14 patients entered sustained clinical remission on LDTA. The cost savings achieved using the LDTA strategy in this group of patients was £146 413 per year with an average saving of £10 458 per patient per year.

conclusionsThis study has identified a significant annual cost savings with this treatment strategy through the prevention of escalation to biologics. These cost savings are likely to be even more significant in the long term since a significant proportion of patients treated with biological therapy require dose escalation. We believe adopting this strategy more widely could lead to significant healthcare savings.

Indexed as

6-MERCAPTOPURINEAZATHIOPRINECOST-EFFECTIVENESSCROHN'S DISEASEINFLAMMATORY BOWEL DISEASE

Identifiers

PMID28839824
PMCPMC5369596
OpenAlexW2124973200

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.