Evaluation of the cost-effectiveness of sirolimus versus cyclosporin for immunosuppression after renal transplantation in the United Kingdom.
TL;DR: In this model analysis, sirolimus was cost-effective compared with cyclosporin for 10 to 20 years after renal transplantation in the United Kingdom, from the perspective of the UK National Health Service and Personal Social Service.
About: This article is published in Clinical Therapeutics.The article was published on 2005-11-01. It has received 30 citations till now. The article focuses on the topics: Cost effectiveness & Transplantation.
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TL;DR: Data mining-based methodology proposed in this study reveals that there are undiscovered relationships among the survival-related variables, which helps better predict the survival of the heart-lung transplants.
117 citations
TL;DR: This long-term follow-up showed that thymoglobulin was associated with higher event-free survival and improved QALYs, without increased posttransplant lymphoproliferative disorder or cytomegalovirus disease, compared with Atgam at 10 years.
Abstract: Background
Use of induction for renal transplantation is controversial due to concerns about long-term safety and efficacy.
78 citations
TL;DR: A new discrete time-state transition economic model (semi-Markov) was developed, with acute rejection, graft function (GRF) and new-onset diabetes mellitus used to extrapolate graft survival.
Abstract: This article is freely available. Click on the 'Additional Link' above to access the full-text.
50 citations
TL;DR: The NLCs show potential to improve the oral bioavailability of sirolimus by encapsulating into lipids-based nanostructured lipid carriers (NLCs), which is similar to that of the commercial nanocrystalline srolimus tablets Rapamune®.
Abstract: The main purpose of this study was to improve the oral bioavailability of sirolimus (SRL), a poorly water-soluble immunosuppressant, by encapsulating into lipids-based nanostructured lipid carriers (NLCs). SRL-loaded NLCs (SRL-NLCs) were prepared by a high-pressure homogenization method with glycerol distearates (PRECIROL ATO-5) as the solid lipid, oleic acid as the liquid lipids, and Tween 80 as the emulsifier. The SRL-NLCs prepared under optimum conditions was spherical in shape with a mean particle size of about 108.3 nm and an entrapment efficiency of 99.81%. In vitro release of SRL-NLCs was very slow, about 2.15% at 12 h, while in vitro lipolysis test showed fast digestion of the NLCs within 1 h. Relative oral bioavailability of SRL-NLCs in Beagle dogs was 1.81-folds that of the commercial nanocrystalline sirolimus tablets Rapamune®. In conclusion, the NLCs show potential to improve the oral bioavailability of SRL.
48 citations
Cites background from "Evaluation of the cost-effectivenes..."
...Sirolimus (SRL) is a macrocyclic lactone immunosuppressant, which is widely used for anti-rejection therapy in organ transplantation (MacDonald et al., 2000; McEwan et al., 2005; Watson & Bradley, 2006; Kubiak et al., 2012)....
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TL;DR: Sirolimus tablets are not only a successful example of nanomedicine, but also a more cost-effective treatment in renal transplantation than cyclosporine and tacrolimus.
Abstract: Nanomedicine, known as the application of nanotechnology in medicine, has been applied to overcome the problems of poor bioavailability, in vitro and in vivo stability, and targeted delivery in the preparation of pharmaceutical products. Sirolimus, a water-insoluble immunosuppressant, has been formulated into an oral solid dosage form by using NanoCrystal® technology to increase the water solubility and thereby the bioavailability. The efficacy, safety, and pharmacokinetic properties are not significantly different between liquid and solid formulations except that less fluctuation of sirolimus blood concentration was observed in solid dosage form. The tablet formulation offers the advantages of better palatability and more convenience for long-term use. Sirolimus tablets are not only a successful example of nanomedicine, but also a more cost-effective treatment in renal transplantation than cyclosporine and tacrolimus.
47 citations
References
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TL;DR: It is concluded that renal transplantation was more effective and less costly than dialysis in all subgroups of patients examined, including patients older than 60 and diabetics.
1,086 citations
TL;DR: Recent improvements in graft half-life are related to conservation of renal function within the first year post-transplantation, and one-year creatinine and Delta Creatinine values predict long-term renal graft survival.
683 citations
TL;DR: On all three continents, ESRD and hemodialysis profoundly affect HRQOL, with patients in the United States having the highest scores on the mental health subscale and the highest mental component summary scores, while in other countries, the effects on mental health are smaller.
331 citations