Evidence mapPaperPMID 38684270Full record

Trial reportBMJ open2024

Cost-effectiveness of methenamine hippurate compared with antibiotic prophylaxis for the management of recurrent urinary tract infections in secondary care: a multicentre, open-label, randomised, non-inferiority trial.

William King, Tara Homer, Chris Harding, Helen Mossop, Thomas Chadwick, Alaa Abouhajar, Luke Vale

Abstract readMulticenter StudyRandomized Controlled TrialEquivalence Trial
In one paragraph

Trial report in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
  2. 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

7 authors.

William KingHealth Economics Group, Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.ORCID 0000-0001-7040-9133
Tara HomerHealth Economics Group, Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK tara.homer@newcastle.ac.uk.ORCID 0000-0002-6664-0671
Chris HardingNewcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Helen MossopNewcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.
Thomas ChadwickNewcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.
Alaa AbouhajarNewcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK.
Luke ValeHealth Economics Group, Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo estimate the cost-effectiveness of methenamine hippurate compared with antibiotic prophylaxis in the management of recurrent urinary tract infections.

designMulticentre, open-label, randomised, non-inferiority trial.

settingEight centres in the UK, recruiting from June 2016 to June 2018.

participantsWomen aged ≥18 years with recurrent urinary tract infections, requiring prophylactic treatment.

interventionsWomen were randomised to receive once-daily antibiotic prophylaxis or twice-daily methenamine hippurate for 12 months. Treatment allocation was not masked and crossover between arms was allowed. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary economic outcome was the incremental cost per quality-adjusted life year (QALY) gained at 18 months. All costs were collected from a UK National Health Service perspective. QALYs were estimated based on responses to the EQ-5D-5L administered at baseline, 3, 6, 9, 12 and 18 months. Incremental costs and QALYs were estimated using an adjusted analysis which controlled for observed and unobserved characteristics. Stochastic sensitivity analysis was used to illustrate uncertainty on a cost-effectiveness plane and a cost-effectiveness acceptability curve. A sensitivity analysis, not specified in the protocol, considered the costs associated with antibiotic resistance.

resultsData on 205 participants were included in the economic analysis. On average, methenamine hippurate was less costly (-£40; 95% CI: -684 to 603) and more effective (0.014 QALYs; 95% CI: -0.05 to 0.07) than antibiotic prophylaxis. Over the range of values considered for an additional QALY, the probability of methenamine hippurate being considered cost-effective ranged from 51% to 67%.

conclusionsOn average, methenamine hippurate was less costly and more effective than antibiotic prophylaxis but these results are subject to uncertainty. Methenamine hippurate is more likely to be considered cost-effective when the benefits of reduced antibiotic use were included in the analysis. TRIAL REGISTRATION NUMBER: ISRCTN70219762.

Indexed as

Antibiotic ProphylaxisCost-Benefit AnalysisHippuratesMethenamineQuality-Adjusted Life YearsUrinary Tract InfectionsAdultAgedAnti-Bacterial AgentsFemaleHumansMiddle AgedRecurrenceUnited KingdomAnti-Bacterial AgentsHippuratesMethenaminemethenamine hippurateHEALTH ECONOMICSQuality of LifeUrinary tract infections

Identifiers

PMID38684270
PMCPMC11086477

What Socratic holds

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Registered trials

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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.