Evidence map›Paper›PMID 32027049›Full record

ArticleClinical transplantation2020

Economic impacts of alternative kidney transplant immunosuppression: A national cohort study.

David A Axelrod, Yasar Caliskan, Mark A Schnitzler, Huiling Xiao, Vikas R Dharnidharka, Dorry L Segev, Mara McAdams-DeMarco, Daniel C Brennan, Henry Randall, Tarek Alhamad and 3 more

Open access · bronzeAbstract read
In one paragraph

Article in Clinical transplantation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 53% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. 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

13 authors at 6 institutions in 1 country.

David A AxelrodUniversity of Iowa Transplant Center, Iowa City, Iowa.ORCID 0000-0001-5684-0613
Yasar CaliskanSaint Louis University Center for Abdominal Transplantation, St. Louis, Missouri.
Mark A SchnitzlerSaint Louis University Center for Abdominal Transplantation, St. Louis, Missouri.
Huiling XiaoSaint Louis University Center for Abdominal Transplantation, St. Louis, Missouri.
Vikas R DharnidharkaDivision of Nephrology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.
Dorry L SegevJohns Hopkins University Transplant Center, Johns Hopkins University, Baltimore, Maryland.
Mara McAdams-DeMarcoJohns Hopkins University Transplant Center, Johns Hopkins University, Baltimore, Maryland.ORCID 0000-0003-3013-925X
Daniel C BrennanJohns Hopkins University Transplant Center, Johns Hopkins University, Baltimore, Maryland.ORCID 0000-0002-4818-7455
Henry RandallSaint Louis University Center for Abdominal Transplantation, St. Louis, Missouri.
Tarek AlhamadDivision of Nephrology, Washington University School of Medicine, St. Louis, Missouri.
Bertram L KasiskeDivision of Nephrology, Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
Gregory HessDrexel University School of Medicine, Philadelphia, Pennsylvania.
Krista L LentineSaint Louis University Center for Abdominal Transplantation, St. Louis, Missouri.ORCID 0000-0002-9423-4849
Saint Louis University · USJohns Hopkins University · USWashington University in St. Louis · USDrexel University · USHennepin County Medical Center · USUniversity of Iowa · US

Funding

Kidney transplantation in older, frail and cognitively impaired adults with ESRD: Balancing utility vs. justiceR01AG055781 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2017 to 2021
$4.2M
Hemodialysis-based interventions to preserve cognitive functionR01DK114074 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2018 to 2022
$3.9M
Developing personalized immunosuppression for older kidney transplant recipientsR01DK120518 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2019 to 2022
$2.7M
Choosing Immune Suppression in Renal Transplantation by Efficacy and MorbidityR01DK102981 · NIDDK · WASHINGTON UNIVERSITY · PI DHARNIDHARKA, VIKAS R. · 2014 to 2018
$1.9M
Patient Oriented Research in Solid Organ TransplantationK24AI144954 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SEGEV, DORRY L. · 2020 to 2024
$956k
NIAID NIH HHS K24 AI144954NIA NIH HHS R01 AG055781NIDDK NIH HHS R01 DK102981NIDDK NIH HHS R01 DK114074NIDDK NIH HHS R01 DK120518
6 · The paper itself

Abstract

Understanding the economic implications of induction and maintenance immunosuppression (ISx) is important in developing personalized kidney transplant (KTx) care. Using data from a novel integrated data set including financial records from the University Health System Consortium, Medicare, and pharmacy claims (2007-2014), we estimated the differences in the impact of induction and maintenance ISx regimens on transplant hospitalization costs and Medicare payments from KTx to 3 years. Use of thymoglobulin (TMG) significantly increased transplant hospitalization costs ($12 006; P = .02), compared with alemtuzumab and basiliximab. TMG resulted in lower Medicare payments in posttransplant years 1 (-$2058; P = .05) and 2 (-$1784; P = .048). Patients on steroid-sparing ISx incurred relatively lower total Medicare spending (-$10 880; P = .01) compared with patients on triple therapy (tacrolimus, antimetabolite, and steroids). MPA/AZA-sparing, mammalian target of rapamycin inhibitors-based, and cyclosporine-based maintenance ISx regimens were associated with significantly higher payments. Alternative ISx regimens were associated with different KTx hospitalization costs and longer-term payments. Future studies of clinical efficacy should also consider cost impacts to define the economic effectiveness of alternative ISx regimens.

Indexed as

Kidney TransplantationAgedCohort StudiesGraft RejectionHumansImmunosuppression TherapyImmunosuppressive AgentsMedicareMycophenolic AcidUnited StatesImmunosuppressive AgentsMycophenolic Acideconomicshealth expendituresinduction immunosuppressionkidney transplantationmaintenance immunosuppressionregistries

Identifiers

PMID32027049
PMCPMC10401861
OpenAlexW3004811204

What OpenQuestion holds

Textmetadata
LicenceTDM
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.