scholarly journals Cost-effectiveness of an Adjuvanted Hepatitis B Vaccine (HEPLISAV-B™) inPatients with Inflammatory Bowel Disease

2020 ◽  
Author(s):  
Juan E Corral ◽  
Joshua Y Kwon ◽  
Freddy Caldera ◽  
Surakit Pungpapong ◽  
Aaron C Spaulding ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Chronic Hepatitis ◽  
Cost Effectiveness ◽  
Hepatitis B ◽  
Acute Hepatitis ◽  
Bowel Disease ◽  
Sensitivity Analyses ◽  
Progression Rate ◽  
Old Patients ◽  
Inflammatory Bowel

Abstract Background Compare the cost-effectiveness of two recombinant hepatitis B vaccines (HBV) in patients with inflammatory bowel disease (IBD). Methods Markov models were developed for two IBD cohorts: A) 40-year-old patients prior to starting IBD treatment and B) 40-year-old patients already receiving therapy. Cohort A received full vaccination series, cohort B had primary vaccine failure and received a vaccine booster. Two vaccines were compared: adjuvanted HEPLISAV-B™ and nonadjuvanted Engerix-B®. Clinical probabilities of acute hepatitis, chronic hepatitis, cirrhosis, fulminant hepatic failure and death, treatment costs and effectiveness estimates were obtained from published literature. A lifetime analysis and a U.S. payer perspective were used. Probabilistic sensitivity analyses were performed for different hypothetical scenarios. Results Analysis of cohort A showed moderate cost-effectiveness of HEPLISAV-B™ ($88,114 per quality adjusted life-year [QALY]). Analysis of cohort B showed increased cost effectiveness ($35,563 per QALY). Changing Engerix-B® to HEPLISAV-B™ in a hypothetical group of 100,000 patients prevented 6 and 30 cases of acute hepatitis; and 4 and 5 cases of chronic hepatitis annually for cohort A and B respectively. It also prevented 1 and 2 cases of cirrhosis, and 1 and 2 deaths over 20 years for each cohort. Cost-effectiveness was determined by vaccination costs, patient age and progression rate from chronic hepatitis to cirrhosis. Conclusions HEPLISAV-B™ is cost-effective over Engerix-B® in patients receiving immunosuppressive therapy for IBD. Benefits increase with population aging and lower costs of vaccines. We advocate measuring protective level of HBV antibodies in patients with IBD and favor adjuvanted vaccines when vaccination is needed.

Prevalence and Outcomes of Chronic Hepatitis B and C in Hospitalized Patients With Inflammatory Bowel Disease

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1557-S1558
Author(s):  
Kefu Li ◽  
Steven Hendler ◽  
Matthew Chang ◽  
Philip N. Okafor ◽  
Kian Keyashian ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Bowel Disease ◽  
Hospitalized Patients ◽  
Inflammatory Bowel

Clinical courses of chronic hepatitis B virus infection and inflammatory bowel disease in patients with both diseases

2012 ◽  
Vol 18 (11) ◽  
pp. 2004-2010 ◽  
Author(s):  
Sang Hyoung Park ◽  
Suk-Kyun Yang ◽  
Young-Suk Lim ◽  
Ju Hyun Shim ◽  
Dong-Hoon Yang ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Virus Infection ◽  
Hepatitis B ◽  
Bowel Disease ◽  
Hepatitis B Virus Infection ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Inflammatory Bowel

Cost-effectiveness of Venous Thromboembolism Prophylaxis After Hospitalization in Patients With Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Kate E Lee ◽  
Francesca Lim ◽  
Jean-Frederic Colombel ◽  
Chin Hur ◽  
Adam S Faye
Keyword(s):  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Bowel Disease ◽  
Sensitivity Analyses ◽  
Vte Prophylaxis ◽  
Life Years ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD) have a 2- to 3-fold greater risk of venous thromboembolism (VTE) than patients without IBD, with increased risk during hospitalization that persists postdischarge. We determined the cost-effectiveness of postdischarge VTE prophylaxis among hospitalized patients with IBD. Methods A decision tree compared inpatient prophylaxis alone vs 4 weeks of postdischarge VTE prophylaxis with 10 mg/day of rivaroxaban. Our primary outcome was quality-adjusted life years (QALYs) over 1 year, and strategies were compared using a willingness to pay of $100,000/QALY from a societal perspective. Costs (in 2020 $USD), incremental cost-effectiveness ratios (ICERs) and number needed to treat (NNT) to prevent 1 VTE and VTE death were calculated. Deterministic 1-way and probabilistic analyses assessed model uncertainty. Results Prophylaxis with rivaroxaban resulted in 1.68-higher QALYs per 1000 persons compared with no postdischarge prophylaxis at an incremental cost of $185,778 per QALY. The NNT to prevent a single VTE was 78, whereas the NNT to prevent a single VTE-related death was 3190. One-way sensitivity analyses showed that higher VTE risk >4.5% and decreased cost of rivaroxaban ≤$280 can reduce the ICER to <$100,000/QALY. Probabilistic sensitivity analyses favored prophylaxis in 28.9% of iterations. Conclusions Four weeks of postdischarge VTE prophylaxis results in higher QALYs compared with inpatient prophylaxis alone and prevents 1 postdischarge VTE among 78 patients with IBD. Although postdischarge VTE prophylaxis for all patients with IBD is not cost-effective, it should be considered in a case-by-case scenario, considering VTE risk profile, costs, and patient preference.

Chronic viral hepatitis and inflammatory bowel disease

2021 ◽  
Vol 11 (2) ◽  
pp. 29-34
Author(s):  
G.V. Volynets ◽  
◽  
A.I. Khavkin ◽  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Immunosuppressive Therapy ◽  
Chronic Hepatitis C ◽  
Bowel Disease ◽  
Chronic Viral Hepatitis ◽  
Inflammatory Bowel

The article presents the results of a literature review devoted to the study of the problems of the combined course of inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn's disease (CD), and chronic viral hepatitis (CVH) – chronic hepatitis B (CHB) and chronic hepatitis C (CHC). The frequency of occurrence of CHB and CHC in IBD in different countries is presented, which ranges from 1 to 9%. The clinical course of these combined diseases, the possibility of reactivation of hepatitis B virus (HBV) and hepatitis C virus (HCV) during immunosuppressive therapy are described. Recommendations on the specifics of examination and management of patients with combined pathology of IBD and CVH are presented. Conclusion. The combined pathology of IBD and CVH is a significant public health problem around the world that requires further large-scale study. The use of immunosuppressive therapy for IBD can be accompanied by the activation of HBV and HCV infection, therefore, the management of such patients should be individualized. Key words: inflammatory bowel disease, chronic hepatitis B, chronic hepatitis C, immunosuppressive therapy

Liver dysfunction related to hepatitis B and C in patients with inflammatory bowel disease treated with immunosuppressive therapy

Gut ◽  
2010 ◽  
Vol 59 (10) ◽  
pp. 1340-1346 ◽  
Author(s):  
C. Loras ◽  
J. P. Gisbert ◽  
M. Minguez ◽  
O. Merino ◽  
L. Bujanda ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Hepatitis B ◽  
Immunosuppressive Therapy ◽  
Liver Dysfunction ◽  
Bowel Disease ◽  
Inflammatory Bowel

Sa1124 A Report on the Prevalence and Reactivation Rate of Hepatitis B Virus in Patients With Inflammatory Bowel Disease in Japan

2014 ◽  
Vol 146 (5) ◽  
pp. S-206
Author(s):  
Yoko Yokoyama ◽  
Mikio Kawai ◽  
Koji Kamikozuru ◽  
Masaki Iimuro ◽  
Nobuyuki Hida ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Bowel Disease ◽  
B Virus ◽  
Inflammatory Bowel

scholarly journals Hepatitis B Virus Reactivation Induced by Infliximab Administration in a Patient with Crohn’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Yuka Miyake ◽  
Aki Hasebe ◽  
Tetsuya Tanihira ◽  
Akiko Shiraishi ◽  
Yusuke Imai ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Hepatitis B Virus ◽  
Crohn's Disease ◽  
Hepatitis B ◽  
Bowel Disease ◽  
Hbv Dna ◽  
Hbv Reactivation ◽  
B Virus ◽  
Inflammatory Bowel

A 47-year-old man diagnosed with Crohn’s disease was treated with infliximab. He tested negative for hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) but positive for anti-HB core antibody (anti-HBc). He tested positive for hepatitis B virus (HBV-) DNA 3 months after treatment and was administered entecavir. HBV-DNA test showed negative results 1 month later. ALT was persistently within the normal range, and HBV-DNA was persistently negative thereafter despite the continuation of infliximab every 8 weeks. In our hospital, 14 patients with inflammatory bowel disease, who tested negative for HBsAg, were treated with infliximab; 2 of them tested positive for anti-HBs and/or anti-HBc, and HBV reactivation was observed in 1 patient (the present patient). The present case and these findings highlight that careful follow-up is needed in patients with inflammatory bowel disease treated with infliximab who test positive for anti-HBc and/or anti-HBs.

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