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From the perspective of health economics, the evaluation of drug-related cost effectiveness and clinical utility is crucial. We conducted a cost-utility analysis of two first-line drugs, tenofovir alafenamide (TAF) and entecavir (ETV), in the treatment of chronic hepatitis B (CHB) patients. We performed inverse probability of treatment weighting (IPTW) to match the independent variables between the two treatment groups. The incremental cost effectiveness ratio (ICER) of the two treatment groups was simulated using a decision tree with the Markov annual-cycle model. A total of 54 patients treated with TAF and 98 with ETV from January 2016 to December 2020 were enrolled. The total medical cost in the TAF group was NT$76,098 less than that in the ETV group, and TAF demonstrated more effectiveness than ETV by 3.19 quality-adjusted life years (QALYs). When the time horizon was set at 30 years, the ICER of the TAF group compared with the ETV group was -NT$23,878 per QALY, suggesting more cost savings for TAF. Additionally, with the application of TAF, over NT$366 million (approximately US$12 million) can be saved annually. TAF demonstrates cheaper medical costs and more favorable clinical QALYs than ETV. To balance health insurance benefits and cost effectiveness, TAF is the optimal treatment for CHB.
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Objective To investigate the protective effects of Coptis chinensis decoction on the metabolic index and renal function of rats with fructose-induced metabolism syndrome (MS).Methods From 56 male Wistar rats,6 were randomly selected as normal control group,the other rats were daily fed with 10％ fructose water for 8 weeks to reproduce the MS model.Twenty-four rats were established successfully as MS model and randomly divided into 4 groups (6 each):model group,Coptis decoction group,tauroursodeoxycholic acid (TUDCA) group and berberine hydrochloride (BH) group.The body weight,visceral fat weight,fasting blood glucose (FBG),fasting insulin (FINS),insulin resistance index (HOMA-IR),cholesterol (TC),triglyceride (TG),systolic blood pressure (SBP),diastolic blood pressure (DBP),urinary N-acetyl-β-D-glucosidase (NAG),urine microalbumin (m-ALB),blood urea nitrogen (BUN) and serum creatinine (Scr) levels were compared between the groups,and the renal pathological changes were observed by light microscopy and electron microscopy.Results The levels of body weight,visceral fat weight,FINS,HOMA-IR,TC,TG,SBP,DBP and urinary NAG were obviously higher in the four MS model groups than in normal control group (P＜0.05),while the levels of m-ALB,BUN and Scr showed no significant difference (P＞0.05).After the intervention,the levels of body weight,visceral fat weight,FINS,HOMA-IR,TC,TG,SBP and DBP decreased significantly in Coptis decoction group than in model group (P＜0.05).Compared with BH group and TUDCA group,the levels of FINS and HOMA-IR decreased obviously in Coptis decoction group (P＜0.05),while the levels of body weight,TC,TG,SBP,DBP,urinary NAG,BUN and Scr showed no significant difference (P＞0.05).It was observed in model group by light microscopy and electron microscopy that the glomerular swelled obviously,the capillary basement membrane of glomerular and renal tubules thickened,mesangial region and interstitial substances hyperplasia,podocytes swelled markedly and most of fusion,the epithelial cells of renal tubules serious vacuolar degeneration,and a lot of secondary lysosomes formed,autophagy of organelles occurred,and most of endoplasmic reticulum and mitochondria disappeared.The kidney pathological damage reduced obviously after treatment of Coptis decoction,but no significant difference when compared with that in BH group and TUDCA group.Conclusions Coptis decoction may decrease the body weight,reduce the levels of blood lipid and blood pressure,and better improve the insulin resistance when compared with BH and TUDCA.In addition,Coptis decoction can also reduce the renal pathological damage,and has the protective function for kidney.
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BACKGROUND: Evidence suggests that ingesting lactic acid bacteria exerts a suppressive effect on Helicobacter pylori infection in both animals and humans. Supplementing with Lactobacillus- and Bifidobacterium-containing yogurt (AB-yogurt) was shown to improve the rates of eradication of H. pylori in humans. OBJECTIVE: We administered AB-yogurt to subjects with asymptomatic H. pylori to test whether the yogurt could inhibit H. pylori growth. DESIGN: The in vitro inhibition of H. pylori growth was determined by inoculating Lactobacillus acidophilus La5 or Bifidobacterium lactis Bb12 on plates that were inoculated with H. pylori. Assessment of the viability of H. pylori was performed by the mixed culture method with La5 or Bb12. In an intervention study, 59 adult volunteers infected with H. pylori were given AB-yogurt (10(7) colony-forming units of both La5 and Bb12/mL) twice daily after a meal for 6 wk. Eleven subjects positive for H. pylori infection were treated with milk placebo as control subjects. H. pylori bacterial loads were determined with use of the (13)C-urea breath test, which was performed before and 4 and 8 wk after the start of AB-yogurt supplementation. RESULTS: Bb12 exerted an in vitro inhibitory effect against H. pylori, whereas La5 did not show an effect. Administration of AB-yogurt decreased the urease activity of H. pylori after 6 wk of therapy (P < 0.0001). CONCLUSION: Regular intake of yogurt containing Bb12 and La5 effectively suppressed H. pylori infection in humans.
