Evidence map›Paper›PMID 39400525›Full record

Trial reportUnited European gastroenterology journal2024

Cost-effectiveness and cost-utility of optimized mercaptopurine treatment versus placebo in ulcerative colitis patients: The randomized controlled OPTIC trial.

Mark Löwenberg, Marit van Barreveld, Adriaan Volkers, Sara van Gennep, Marjolijn Duijvestein, Adriaan A van Bodegraven, Melanie S Hulshoff, Jeroen M Jansen, Dirk van Asseldonk, Rachel West and 3 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in United European gastroenterology journal, 2024. 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
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. Trial
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.

Mark LöwenbergDepartment of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Marit van BarreveldDepartment of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Adriaan VolkersDepartment of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands.ORCID 0000-0002-9547-1627
Sara van GennepDepartment of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Marjolijn DuijvesteinDepartment of Gastroenterology and Hepatology, Radboudumc, Nijmegen, The Netherlands.
Adriaan A van BodegravenDepartment of Gastroenterology, Zuyderland Medical Centre and Maastricht University Medical Center, Sittard, The Netherlands.
Melanie S HulshoffDepartment of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands.ORCID 0000-0002-1792-2533
Jeroen M JansenDepartment of Gastroenterology and Hepatology, OLVG, Amsterdam, The Netherlands.
Dirk van AsseldonkDepartment of Gastroenterology and Hepatology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
Rachel WestDepartment of Gastroenterology and Hepatology, Franciscus Gasthuis, Rotterdam, The Netherlands.
Geert D'HaensDepartment of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Nanne de BoerDepartment of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Marcel G W DijkgraafDepartment of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Funding

ZonMw 836041002
6 · The paper itself

Abstract

BACKGROUND AND

aimsWe assessed the cost-effectiveness and cost-utility of therapeutic drug monitoring (TDM)-guided mercaptopurine treatment compared with placebo in ulcerative colitis (UC) patients failing 5-aminosalicylates.

methodsData were gathered alongside the randomized controlled OPTIC trial (EudraCT: 2015-005260-41). The evaluation was performed from a health care and societal perspective as cost-effectiveness and cost-utility analyses with a time horizon of one year. Volumes and costs of in-hospital care, out-of-hospital care, out-of-pocket expenses and productivity loss were assessed. The main outcomes were the extra costs per additional patient who achieved clinical remission and endoscopic improvement at 52 weeks (responders) and extra costs per quality-adjusted life-year (QALY) gained.

resultsIn total, 59 patients were randomized to the intervention (n = 29) and control (n = 30) group. Non-significant differences in costs were €63 (-€1267 to €1434; P = 0.93) in favour of placebo from a health care perspective and -€742 (-€3683 to €2016; P = 0.64) in favour of mercaptopurine from a societal perspective. The higher proportion of responders and a non-significant QALY difference of 0.0475 (-0.024-0.117) (P = 0.184) favouring patients on mercaptopurine treatment resulted in €165 extra costs per additional responder and €1326 extra costs per QALY gained from a health care perspective. From a societal perspective, dominance over placebo was observed with cost savings of €1937 per additional responder and €15,621 per QALY gained. The probability of optimised mercaptopurine treatment being cost-effective was 0.80 at a willingness to pay per additional QALY of €20,000.

conclusionsTDM-based mercaptopurine treatment in UC patients failing 5-aminosalicylates is a cost-effective strategy from a societal perspective.

Indexed as

Colitis, UlcerativeCost-Benefit AnalysisMercaptopurineQuality-Adjusted Life YearsAdultDrug MonitoringFemaleHumansImmunosuppressive AgentsMaleMesalamineMiddle AgedRemission InductionTreatment OutcomeImmunosuppressive AgentsMercaptopurineMesalamine6‐mercaptopurinecostsIBDinflammatory bowel diseaseof therapeutic drug monitoringTDMthiopurines

Identifiers

PMID39400525
PMCPMC11578840

What OpenQuestion holds

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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.