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Heberprot-P’s Effect on Gene Expression in Healing Diabetic Foot Ulcers
OBJECTIVE Analyze changes in expression of genes involved in healing after treatment of diabetic foot ulcers with Heberprot-P.
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Pharmacoeconomic analysis of epidermal growth factor (HeberprotP ®)
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More than 900 Patients Benefit with Heberprot-P in Las Tunas
Las Tunas, Cuba.- Some 936 patients from this eastern province benefited with the application of Heberprot-P, through the comprehensive program for the detection and treatment of diabetic foot ulcers (DFU).
Yeen Hernández, national promoter of the drug from the Center for Genetic Engineering and Biotechnology (CIGB), explained that the province has achieved commendable results for several years, and in 2016 maintained the integrality in all indicators, with an increase above 26, 9 percent in the inclusion of new patients.
Research for the early detection of DFU was decisive in reducing the number of amputations: only seven were recorded, demonstrating the effectiveness of the drug and the quality of the attention in primary health care institutions.
Hernández insisted on the importance of prevention to avoid complications of diabetes mellitus. At the same time he urged the professionals to continue the systematic labor and maintain the cohesion of the work team that make this program an example of good practices within the sector.
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Treatment of Trophic ulcer (HEBERPROT-P )
Trophic ulcer (diabetic foot) is one of the most dangerous complications of the diabetes.
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Due to constantly high blood sugar, diabetic patients have a disordered nervous conductivity in feet, which results in sensory loss, nonreactive for pressure, cold, various foot injuries. Any skin injury can lead to infection penetration and purulence (neuropathic foot). One more presentation of the neuropathic trophic ulcer is that leg skin loses its sensory to sweat and a dry skin often chaps but dry heels do not bother patients for lack of pain syndrome, which can result in ulceration.
Other kind of diabetic ulcers on feet is ischemic trophic ulcers emerging from disturbed circulation in foot vessels. Without sufficient nutrition, skin becomes too vulnerable for any injuries, which are hardly to be healed. Most commonly mixed form of diabetic foot infections takes place
Foot problems, which can lead to trophic ulcers:
- corns and clavuses,
- ingrown nail,
- onychomycosis,
- plantar wart,
- dry and cracked skin,
- skin fungus disease, especially between toes.
Treatment neglecting is highly prohibited as it can lead to serious consequences.
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Cost-Utility Analysis of Heberprot-P
Objectives: To explore whether Heberprot-P (an epidermal growth factor) is a cost-effective option for the treatment of advanced diabetic foot ulcer as an add-on therapy to good wound care (GWC) in Slovakia from the perspective of health care payers.
Methods: A Markov model was constructed to compare the costs and effects of Heberprot-P plus GWC to those of GWC alone from the perspective of health care payers. The 52-week clinical trial period was extended to 5- and 10-year time horizons. Transition probabilities were calculated based on a previous clinical trial of Heberprot, utility values were derived from the scientific literature, and cost vectors were collected from the General Health Insurance Fund database in Slovakia. A one-way deterministic sensitivity analysis was employed to explore the influence of uncertainty for each input parameter on the incremental cost-effectiveness ratio (ICER).
Results: Based on the ICER threshold of €30,030 per quality-adjusted life year (QALY) recommended by the Slovak Ministry of Health, Heberprot-P therapy plus GWC is not a cost-effective alternative to GWC alone over a 10-year time horizon. The ICER increases if a longer time horizon is applied, as the incremental costs are similar, but the aggregated utility gain from avoided amputation is lower. Based on the sensitivity analysis, the utility multiplier for the health state “no ulcer after small amputation” had the most impact on the ICER; however, the model was robust to changes in all input parameters.
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Heberprot-P Part one
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