Objective: The purpose of this study is to simulate the cost-effectiveness and the long-term clinical performance of the Barostim neo System for the treatment of resistant hypertension when compared to optimal medical treatment.
Methods: A decision analytic model with a combination of a decision tree and Markov process was used to evaluate the cost-effectiveness of Barostim. The clinical effectiveness of Barostim was based on the results of the randomized, placebo-controlled Rheos trial and the follow-up substudy of the DEBuT-HT trial. The cost-effectiveness was modelled from a German societal perspective over a lifetime horizon. Patients with high SBP levels have an increased risk of myocardial infarction, stroke, heart failure and end-stage renal disease.
Results: In a simulated cohort of 50-year-old patients at high risk of end-organ damage, Barostim therapy generated 1.66 additional life-years and 2.17 additional quality-adjusted life years with an incremental cost of &OV0556;16 891 when compared with continuation of medical management. Barostim was estimated to be cost-effective compared with optimal medical treatment with an incremental cost-effectiveness ratio of &OV0556;7 797/QALY. In the model, Barostim reduced over a lifetime the rates of myocardial infarction by 19%, stroke by 35%, heart failure by 12% and end-stage renal disease by 23%. The cost-effectiveness of Barostim can be greater in younger patients with resistant hypertension and in patients with significant risk factors for end-organ damage.
Conclusion: Barostim may be a cost-effective treatment when compared with optimal medical management in patients with resistant hypertension.
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http://dx.doi.org/10.1097/HJH.0000000000000071 | DOI Listing |
J Appl Physiol (1985)
January 2025
Medical Physics Graduate Program, Duke University, Durham, North Carolina, United States.
Hyperpolarized Xe MRI/MRS enables quantitative mapping of function in lung airspaces, membrane tissue, and red blood cells (RBCs) within the pulmonary capillaries. The RBC signal also exhibits cardiogenic oscillations that are reduced in pre-capillary pulmonary hypertension (PH). This effect is obscured in patients with concomitant defects in transfer from airspaces to RBCs, which increase RBC oscillation amplitudes.
View Article and Find Full Text PDFInterstitial lung disease (ILD) can lead to pulmonary hypertension (ILD-PH), worsening prognosis and increasing mortality. Diagnosing ILD-PH is challenging due to the limitations of imaging methods. Right heart catheterization (RHC) is the gold standard for diagnosing PH but is limited to ILD patients considered for lung transplantation.
View Article and Find Full Text PDFEur Cardiol
December 2024
Department of Respiratory Medicine, King George's Medical University Lucknow, Uttar Pradesh, India.
Pulmonary arterial hypertension (PAH) is a long-term condition characterised by increased resistance to blood flow in the pulmonary circulation. The disease has a progressive course and is associated with a poor prognosis. Without treatment, PAH is associated with mortality in <3 years.
View Article and Find Full Text PDFFront Endocrinol (Lausanne)
January 2025
Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China.
Aim: Previous research has shown a strong association between insulin resistance (IR) and both the onset and advancement of diabetic kidney disease (DKD). This research focuses on examining the relationship between IR and all-cause mortality in individuals with DKD.
Methods: This study utilized data obtained from the National Health and Nutrition Examination Survey (NHANES), spanning the years 2001 to 2018.
Nephrology (Carlton)
February 2025
Phoenix Children's Hospital-Thomas Campus, Phoenix, Arizona, USA.
Complement 3 glomerulonephritis (C3GN) is a rare glomerular disease involving dysregulation of the complement system. We describe our experience using pegcetacoplan, an inhibitor of C3 and its activation fragment, C3b, for treatment-resistant C3GN in a 9-year-old boy referred for evaluation of refractory membranoproliferative glomerulonephritis. Despite treatment with intense immunosuppression (high-dose steroids, mycophenolate mofetil and calcineurin inhibitor), he continued to have high disease activity with low C3 levels (35 mg/dL), hypertension, symptomatic oedema, anaemia, and nephrotic-range proteinuria (e.
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