BACKGROUND Pancreatic exocrine insufficiency(PEI)leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy(PERT).Patients suffering from PEI in China are more ...BACKGROUND Pancreatic exocrine insufficiency(PEI)leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy(PERT).Patients suffering from PEI in China are more likely not to receive adequate treatment as this drug is not part of the Chinese national essential medicine list.AIM To examine the cost-effectiveness of PERT for patients suffering from PEI in China.METHODS A decision analytical Markov model was constructed to simulate the progress of patients with PEI in China.The population included in the analyses were patients suffering from PEI with advanced(non-resectable)pancreatic cancer,who have undergone surgery due to pancreatic cancer and who have undergone endoscopic treatment due to chronic pancreatitis.The cost-effectiveness analyses were undertaken from a Chinese societal perspective comparing PERT with no PERT.The incremental cost-effectiveness ratio in United States dollars per quality adjusted life year(QALY)gained is the main outcome.Input was informed by publicly available data supplemented with expert clinical advice.RESULTS The cost-effectiveness analyses estimated that PERT resulted in additional 0.45 to 2.93 QALYs at discounted costs of between 4315 dollars to 15193 dollars.This resulted in an incremental cost-effectiveness ratio of 5178 dollars to 9533 dollars per QALY.The one-way sensitivity analyses showed that the main drivers of the model were the cost of PERT and overall survival.CONCLUSION This study demonstrates that PERT is a cost-effective treatment for patients suffering from PEI in China.展开更多
To the Editor：Henoch-Schonlein purpura （HSP） is a generalized vasculitis that can cause a large variety of symptoms in different organs.[1,2] It usually presents as acute-onset palpable purpura mainly located on th...To the Editor：Henoch-Schonlein purpura （HSP） is a generalized vasculitis that can cause a large variety of symptoms in different organs.[1,2] It usually presents as acute-onset palpable purpura mainly located on the lower extremities.Acute pancreatitis （AP） is a potentially life-threatening inflammatory disorder and rarely presents as a complication of HSP.AP secondary to HSP is extremely rare,[3] and it is even rarer as an initial presenting feature of HSP before the occurrence of characteristic palpable purpura.We herein described a patient whose underlying HSP became clinically apparent after the development of AP.To the best of our knowledge,this is a very rare report of recurrent AP induced by HSP.展开更多
To the Editor： Acute pancreatitis （AP） is a common digestive disorder with a broad spectrum of etiologies, Apart from gallstones and alcohol abuse which are two of most common etiologies of AP, all of other potenti...To the Editor： Acute pancreatitis （AP） is a common digestive disorder with a broad spectrum of etiologies, Apart from gallstones and alcohol abuse which are two of most common etiologies of AP, all of other potential causes need to be considered. Pancreatectomy is the surgical removal of all or part of the pancreas, which includes pancreaticoduodenectomy （PD）, distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy.展开更多
文摘BACKGROUND Pancreatic exocrine insufficiency(PEI)leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy(PERT).Patients suffering from PEI in China are more likely not to receive adequate treatment as this drug is not part of the Chinese national essential medicine list.AIM To examine the cost-effectiveness of PERT for patients suffering from PEI in China.METHODS A decision analytical Markov model was constructed to simulate the progress of patients with PEI in China.The population included in the analyses were patients suffering from PEI with advanced(non-resectable)pancreatic cancer,who have undergone surgery due to pancreatic cancer and who have undergone endoscopic treatment due to chronic pancreatitis.The cost-effectiveness analyses were undertaken from a Chinese societal perspective comparing PERT with no PERT.The incremental cost-effectiveness ratio in United States dollars per quality adjusted life year(QALY)gained is the main outcome.Input was informed by publicly available data supplemented with expert clinical advice.RESULTS The cost-effectiveness analyses estimated that PERT resulted in additional 0.45 to 2.93 QALYs at discounted costs of between 4315 dollars to 15193 dollars.This resulted in an incremental cost-effectiveness ratio of 5178 dollars to 9533 dollars per QALY.The one-way sensitivity analyses showed that the main drivers of the model were the cost of PERT and overall survival.CONCLUSION This study demonstrates that PERT is a cost-effective treatment for patients suffering from PEI in China.
文摘To the Editor：Henoch-Schonlein purpura （HSP） is a generalized vasculitis that can cause a large variety of symptoms in different organs.[1,2] It usually presents as acute-onset palpable purpura mainly located on the lower extremities.Acute pancreatitis （AP） is a potentially life-threatening inflammatory disorder and rarely presents as a complication of HSP.AP secondary to HSP is extremely rare,[3] and it is even rarer as an initial presenting feature of HSP before the occurrence of characteristic palpable purpura.We herein described a patient whose underlying HSP became clinically apparent after the development of AP.To the best of our knowledge,this is a very rare report of recurrent AP induced by HSP.
文摘To the Editor： Acute pancreatitis （AP） is a common digestive disorder with a broad spectrum of etiologies, Apart from gallstones and alcohol abuse which are two of most common etiologies of AP, all of other potential causes need to be considered. Pancreatectomy is the surgical removal of all or part of the pancreas, which includes pancreaticoduodenectomy （PD）, distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy.
