Quantifying patient centered outcomes associated with the use of bilateral endobronchial coil treatment in patients with severe emphysema

Publication

Quantifying patient centered outcomes associated with the use of bilateral endobronchial coil treatment in patients with severe emphysema

Journal Paper/Review - May 8, 2018

Evans Rachel, Slebos Dirk-Jan, Shah Pallav, Sculpher Mark, Munavvar Mohammed, Morton Tim, Mealing Stuart, Hartman Jorine, Franzen Daniel, Fellrath Jean-Marc, de Soyza Antony, Deslee Gaetan, Busca Rachele, Brutsche Martin, Durand-Zaleski Isabelle

Citation

Evans R, Slebos D, Shah P, Sculpher M, Munavvar M, Morton T, Mealing S, Hartman J, Franzen D, Fellrath J, de Soyza A, Deslee G, Busca R, Brutsche M, Durand-Zaleski I. Quantifying patient centered outcomes associated with the use of bilateral endobronchial coil treatment in patients with severe emphysema. Curr Med Res Opin 2018; 34:1927-1932.

Type

Journal Paper/Review (English)

Journal

Curr Med Res Opin 2018; 34

Publication Date

May 8, 2018

Issn Electronic

1473-4877

Pages

1927-1932

Brief description/objective

OBJECTIVE
To determine the impact of endobronchial coils on health-related quality-of-life (HRQoL). This paper utilizes trial data to identify the predictors of HRQoL in patients with severe emphysema, and subsequently estimates the impact of a new treatment on HRQoL (measured by utilities). These utility estimates are used to generate indicative long-term QALY estimates for a range of clinically plausible scenarios as a precursor to cost-effectiveness analyses.

METHODS
Patient level HRQoL data from RENEW and the National Emphysema Treatment Trial (NETT) were combined and mapped to generic EuroQol 5-dimension health utility questionnaire (EQ-5D) values using a published algorithm. Multilevel statistical models were developed using treatment, time, response, and baseline characteristics (EQ-5D, age, gender, FEV1, lung RV) to predict EQ-5D over time. Lifetime QALY estimates were generated using published survival data from NETT (assuming no impact of treatment on mortality) and four clinically plausible response profiles. Each response profile was combined with assumptions around treatment impact (constant or time varying).

RESULTS
After controlling for baseline characteristics, both treatment and response had a statistically significant impact (p < .001) on utility (+0.101 and +0.061, respectively). When combined with selected baseline characteristics and time, Coils and Standard of Care (SoC) generated more QALYs than SoC alone in all scenarios, with incremental lifetime benefit ranging from 0.29-0.55 QALYs.

CONCLUSIONS
Coils and SoC resulted in statistically significant improvements in HRQoL compared to SoC alone in patients with severe emphysema.