Evidence map›Paper›PMID 36331936›Full record

ArticlePloS one2022

Mesenchymal stromal cell therapy compared to SGLT2-inhibitors and usual care in treating diabetic kidney disease: A cost-effectiveness analysis.

Luke E Barry, Grainne E Crealey, Paul Cockwell, Stephen J Elliman, Matthew D Griffin, Alexander P Maxwell, Timothy O'Brien, Norberto Perico, Ciaran O'Neill

Open access · goldAbstract readComparative Study
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 3 countries.

Luke E BarryCentre for Public Health, Queen's University Belfast, Belfast, United Kingdom.ORCID 0000-0001-7772-4822
Grainne E CrealeyJohn E. Cairnes School of Business and Economics, National University of Ireland, Galway (NUIG), Galway, Ireland.
Paul CockwellQueen Elizabeth Hospital, University Hospitals Birmingham and Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom.
Stephen J EllimanOrbsen Therapeutics Ltd., Galway, Ireland.
Matthew D GriffinRegenerative Medicine Institute (REMEDI) at CÚRAM SFI Centre For Research in Medical Devices, School of Medicine, National University of Ireland, Galway (NUIG), Galway, Ireland.
Alexander P MaxwellCentre for Public Health, Queen's University Belfast, Belfast, United Kingdom.ORCID 0000-0002-6110-7253
Timothy O'BrienRegenerative Medicine Institute (REMEDI) at CÚRAM SFI Centre For Research in Medical Devices, School of Medicine, National University of Ireland, Galway (NUIG), Galway, Ireland.
Norberto PericoIstituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.
Ciaran O'NeillCentre for Public Health, Queen's University Belfast, Belfast, United Kingdom.ORCID 0000-0001-7668-3934
Ollscoil na Gaillimhe – University of Galway · IEQueen's University Belfast · GBMario Negri Institute for Pharmacological Research · ITOrbsen Therapeutics (Ireland) · IEQueen Elizabeth Hospital Birmingham · GB

Funding

Medical Research Council MC_PC_15025
6 · The paper itself

Abstract

BACKGROUND AND

objectivesTo simulate the cost-effectiveness of Mesenchymal Stromal Cell (MSC) therapy compared to sodium/glucose co-transporter 2 inhibitors (SGLT2i) or usual care (UC) in treating patients with Diabetic Kidney Disease (DKD). DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: This Markov-chain Monte Carlo model adopted a societal perspective and simulated 10,000 patients with DKD eligible for MSC therapy alongside UC using a lifetime horizon. This cohort was compared with an SGLT2i alongside UC arm and a UC only arm. Model input data were extracted from the literature. A threshold of $47,000 per quality-adjusted life year and a discount rate of 3% were used. The primary outcome measure was incremental net monetary benefit (INMB). Sensitivity analysis was conducted to examine: parameter uncertainty; threshold effects regarding MSC effectiveness and cost; and INMB according to patient age (71 vs 40 years), sex, and jurisdiction (UK, Italy and Ireland).

resultsWhile MSC was more cost-effective than UC, both the UC and MSC arms were dominated by SLGT2i. Relative to SGLT2i, the INMB's for MSC and UC were -$4,158 and -$10,085 respectively indicating that SGLT2i, MSC and UC had a 64%, 34% and 1% probability of being cost-effective at the given threshold, respectively. This pattern was consistent across most scenarios; driven by the relatively low cost of SGLT2i and demonstrated class-effect in delaying kidney failure and all-cause mortality. When examining younger patients at baseline, SGLT2i was still the most cost-effective but MSC performed better against UC given the increased lifetime benefit from delaying progression to ESRD.

conclusionsThe evidence base regarding the effectiveness of MSC therapy continues to evolve. The potential for these therapies to reverse kidney damage would see large improvements in their cost-effectiveness as would targeting such therapies at younger patients and/or those for whom SGLT2i is contra-indicated.

Indexed as

Diabetes MellitusDiabetic NephropathiesMesenchymal Stem CellsSodium-Glucose Transporter 2 InhibitorsAdultCost-Benefit AnalysisHumansQuality-Adjusted Life YearsSodium-Glucose Transporter 2Sodium-Glucose Transporter 2Sodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID36331936
PMCPMC9635741
OpenAlexW4308193146

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.