Evidence map›Paper›PMID 38621719›Full record

Trial reportNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2024

Rituximab or cyclosporine A for the treatment of membranous nephropathy: economic evaluation of the MENTOR trial.

Matthew Kadatz, Scott Klarenbach, Helen So, Fernando C Fervenza, Daniel C Cattran, Sean J Barbour, MENTOR Study Investigators

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 18% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Membranous Nephropathy.Journal of clinical medicine · 2025
    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

7 authors at 5 institutions in 3 countries.

Matthew KadatzDivision of Nephrology, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Scott KlarenbachDivision of Nephrology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada.
Helen SoDivision of Nephrology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada.
Fernando C FervenzaDivision of Nephrology & Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States.ORCID 0000-0002-9952-209X
Daniel C CattranDivision of Nephrology, Faculty of Medicine, University of Toronto, Toronto, Canada.
Sean J BarbourDivision of Nephrology, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
MENTOR Study Investigators
University of British Columbia · CAUniversity of Toronto · CAMayo Clinic · USUniversity of Alberta · CAVancouver Coastal Health · CA

Funding

Fulk Family Foundation
6 · The paper itself

Abstract

background and hypothesisThe MENTOR trial (MEmbranous Nephropathy Trial Of Rituximab) showed that rituximab was noninferior to cyclosporine in inducing complete or partial remission of proteinuria and was superior in maintaining proteinuria remission. However, the cost of rituximab may prohibit first-line use for some patients and health-care payers.

methodsA Markov model was used to determine the incremental cost-effectiveness ratio (ICER) of rituximab compared with cyclosporine for the treatment membranous nephropathy from the perspective of a health-care payer with a lifetime time horizon. The model was informed by data from the MENTOR trial where possible; additional parameters including cost and utility inputs were obtained from the literature. Sensitivity analyses were performed to evaluate the impact of reduced-cost biosimilar rituximab.

resultsRituximab for the treatment of membranous nephropathy was cost effective (assuming a willingness-to-pay threshold of $50 000 per quality-adjusted life year (QALY) gained; in $US 2021) compared with cyclosporine, with an ICER of $8373/QALY over a lifetime time horizon. The incremental cost of rituximab therapy was $28 007 with an additional 3.34 QALYs compared with cyclosporine. Lower cost of rituximab biosimilars resulted in a more favorable ICER, and in some cases resulted in rituximab being dominant (lower cost and great benefit) compared to cyclosporine.

conclusionsDespite the greater cost of rituximab, it may be a cost-effective option for the treatment of membranous nephropathy when compared with cyclosporine. The cost-effectiveness of rituximab is further improved with the use of less expensive biosimilars.

Indexed as

Cost-Benefit AnalysisCyclosporineGlomerulonephritis, MembranousImmunosuppressive AgentsRituximabFemaleHumansImmunologic FactorsMaleMarkov ChainsMiddle AgedQuality-Adjusted Life YearsCyclosporineImmunologic FactorsImmunosuppressive AgentsRituximabcost-effectivenesscyclosporineeconomic evaluationmembranous nephropathyrituximab

Identifiers

PMID38621719
PMCPMC11596091
OpenAlexW4394853850

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.