Evidence map›Paper›PMID 35733076›Full record

ArticlePharmacoEconomics - open2022

Economic Evaluation of Using Daily Prednisolone versus Placebo at the Time of an Upper Respiratory Tract Infection for the Management of Children with Steroid-Sensitive Nephrotic Syndrome: A Model-Based Analysis.

Nafsika Afentou, Emma Frew, Samir Mehta, Natalie J Ives, Rebecca L Woolley, Elizabeth A Brettell, Adam R Khan, David V Milford, Detlef Bockenhauer, Moin A Saleem and 12 more

Open access · goldAbstract read
In one paragraph

Article in PharmacoEconomics - open, 2022. 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
–field-weighted citation impact, top 89% 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, 1 citations in OpenAlex.

  1. KDOQI US Commentary on the KDIGO 2025 Clinical Practice Guideline for the Management of Nephrotic Syndrome in Children.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026
    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

22 authors at 13 institutions in 1 country.

Nafsika AfentouHealth Economics Unit, University of Birmingham, Birmingham, UK.
Emma FrewHealth Economics Unit, University of Birmingham, Birmingham, UK. E.Frew@bham.ac.uk.ORCID http://orcid.org/0000-0002-5462-1158
Samir MehtaBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Natalie J IvesBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Rebecca L WoolleyBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Elizabeth A BrettellBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
Adam R KhanBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.
David V MilfordDepartment of Paediatric Nephrology, Birmingham Children's Hospital, Birmingham, UK.
Detlef BockenhauerDepartment of Renal Medicine, University College London, London, UK.
Moin A SaleemSchool of Clinical Sciences, University of Bristol, Bristol, UK.
Angela S HallLeicester Children's Hospital, Leicester, UK.
Ania KoziellChild Health Clinical Academic Group, King's College London, London, UK.
Heather MaxwellDepartment of Paediatric Nephrology, Royal Hospital for Sick Children, Glasgow, UK.
Shivaram HegdeDepartment of Paediatric Nephrology, University Hospital of Wales, Cardiff, UK.
Eric FinlayDepartment of Paediatric Nephrology, Leeds Children's Hospital, Leeds, UK.
Rodney D GilbertDepartment of Paediatric Nephrology, Southampton Children's Hospital, Southampton, UK.
Caroline JonesDepartment of Paediatric Nephrology, Alder Hey Children's Hospital, Liverpool, UK.
Karl McKeeverDepartment of Paediatric Nephrology, Royal Hospital for Sick Children, Belfast, UK.
Wendy CookNephrotic Syndrome Trust (NeST), Taunton, UK.
Nicholas J A WebbDepartment of Paediatric Nephrology, University of Manchester, Manchester, UK.
Martin T ChristianDepartment of Paediatric Nephrology, Nottingham Children's Hospital, Nottingham, UK.
PREDNOS Collaborative Group, NIHR Medicines for Children Research Network Nephrology Clinical Studies Group
Cancer Research UK Clinical Trials Unit · GBRoyal Hospital for Children · GBUniversity of Birmingham · GBUniversity of Manchester · GBUniversity of Liverpool · GBBirmingham Children's Hospital · GBLeicester General Hospital · GBLeeds Teaching Hospitals NHS Trust · GBBristol Royal Hospital for Children · GBGreat Ormond Street Hospital · GBKing's College London · GBSouthampton Children's Hospital · GBUniversity Hospital of Wales · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildhood steroid-sensitive nephrotic syndrome is a frequently relapsing disease with significant short- and long-term complications, leading to high healthcare costs and reduced quality of life for patients. The majority of relapses are triggered by upper respiratory tract infections (URTIs) and evidence shows that daily low-dose prednisolone at the time of infection may reduce the risk of relapse.

objectiveThe aim of this study was to assess the cost effectiveness of a 6-day course of low-dose prednisolone at the start of a URTI when compared with placebo.

methodsA state-transition Markov model was developed to conduct a cost-utility analysis with the outcome measured in quality-adjusted life-years (QALYs). Resource use and outcome data were derived from the PREDNOS2 trial. The analysis was performed from a UK National Health Service perspective and the results were extrapolated to adulthood. Model parameter and structural uncertainty were assessed using sensitivity analyses.

resultsThe base-case results showed that administering low-dose prednisolone at the time of a URTI generated more QALYs and a lower mean cost at 1 year compared with placebo. In the long-term, low-dose prednisolone was associated with a cost saving (£176) and increased effectiveness (0.01 QALYs) compared with placebo and thus remained the dominant treatment option. These findings were robust to all sensitivity analyses.

conclusionA 6-day course of low-dose prednisolone at the time of a URTI in children with steroid-sensitive nephrotic syndrome has the potential to reduce healthcare costs and improve quality of life compared with placebo.

Identifiers

PMID35733076
PMCPMC9283622
OpenAlexW4283311445

What OpenQuestion holds

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LicenceCC BY-NC
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.