Author(s): Lazebnik LB, GusenZade MG, Kniazev OV, Efremov LI, Ruchkina IN
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Abstract The aim of the study was to develop economically motivated decision to use MSSK therapy in patients with colitis (UC). In accordance with the intended purpose it was necessary to determine the effect of MSSK transplantation on clinical and morphological characteristics of the UC, and evaluate the safety and cost-effectiveness of this therapy for the patient. MATERIAL AND METHODS: The study included 39 patients with ulcerative colitis--UC (1 group). In the comparison group (2 nd group) were included 30 patients with UC. For 2-3 days prior to the MSSK induction was terminated immunosuppressants, was reduced the dose of corticosteroids to 15-20 mg/and day dose of aminosalicylate was left at the level of 2.0 g/day. To quantify the results were used the average values of indices of Rachmilevitz clinical activity, Mayo and Geb's scales. Monitoring of patients continued to terms ranging from 4 to 8 months. Bone marrow cells were obtained from the sternum or the iliac crest donor. Cultivation was carried out for 5-6 weeks, than we received an allogeneic MSSK donor population in the number (1,5-2) x 108 cells needed for patient transplant. The culture of MSCs were injected in the drip i.v. at once. Clinical activity was assessed UC scored using an Rachmilevitz index. Endoscopic picture of UC was assessed with help of a Mayo scale. Assessment of histological UC preparations was conducted on a Geb's scale. Was conducted pharmacoeconomic analysis (direct costs and cost-effectiveness) of the MSSK-therapy of patients with UC that were compared with standard therapy. CONCLUSION: Most adult patients with UC are economically active population. Average cost (direct costs) of standard and MSSK-therapy patients with UC in the hospital (direct costs) amounted to 26645,9 +/- 1776,1 and 35395 +/- 6532,1 rubles, respectively. Patients with UC after applying MSSK noted a statistically significant reduce of clinical and morphological indices of inflammatory process activity and decrease in frequency of relapses compared to standard therapy. This was accompanied by a decline in demand for glucocorticosteroid and others LP and contributed to additional savings of treatment costs. Transplantation MSSK can be evaluated as a new strategic direction in the therapy of IBD is very relevant, at least in Russia.
This article was published in Eksp Klin Gastroenterol
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