Title |
Fluconazole versus mould-active triazoles for primary antifungal prophylaxis in adult patients with acute lymphoblastic leukemia: clinical outcome and cost-effectiveness analysis
|
---|---|
Published in |
International Journal of Hematology, October 2017
|
DOI | 10.1007/s12185-017-2342-x |
Pubmed ID | |
Authors |
Yan Wang, Yuanming Xing, Lu Chen, Ti Meng, Ying Li, Jiao Xie, Limei Chen, Yalin Dong, Weihua Dong |
Abstract |
This study evaluated the clinical and cost-effectiveness of prophylactic use of fluconazole versus mould-active triazoles (voriconazole and posaconazole) in adult patients with acute lymphoblastic leukemia (ALL). A decision analytical model was developed with inputs from a 7-year retrospective study (2009-2016) of 103 consecutive adult patients with ALL who received antifungal prophylaxis. Information on the administration of antifungal agents, clinical outcomes, and costs were collected. One-way sensitivity analyses and probabilistic sensitivity analysis were performed. The mould-active triazoles group was associated with higher life-years (3.71 vs 3.59) and lower total costs (US$4886 vs US$5722) per patient compared with fluconazole. One-way sensitivity analyses revealed that varying all of the key variables in the model did not affect the robustness of the results. Probabilistic sensitivity analysis demonstrated that mould-active triazoles had a probability of 77.1 and 90.1% of providing a dominant and cost-effective option relative to fluconazole, respectively. Mould-active triazoles should be regarded as preferable to fluconazole as the first-line prophylactic for adult patients with ALL accompanied by uncommon severe vinca alkaloid-induced neurotoxicity. However, the results reported here should be interpreted with caution owing to the observational nature of the data. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 14 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 2 | 14% |
Student > Doctoral Student | 2 | 14% |
Professor | 2 | 14% |
Student > Ph. D. Student | 2 | 14% |
Researcher | 2 | 14% |
Other | 2 | 14% |
Unknown | 2 | 14% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 5 | 36% |
Medicine and Dentistry | 2 | 14% |
Biochemistry, Genetics and Molecular Biology | 1 | 7% |
Unknown | 6 | 43% |