SYSTEMATIC REVIEW OF PUBLISHED META-ANALYSES, SYSTEMATIC REVIEWS, AND HEALTH TECHNOLOGY ASSESSMENTS OF RITUXIMAB FOR THE TREATMENT OF NON-HODGKIN LYMPHOMA
Author(s)
Santos EA, Minowa ERoche Brazil, Sao Paulo, SP, Brazil
Presentation Documents
OBJECTIVES: To perform a review of the published meta-analyses, systematic reviews and health technology assessments reports (HTAR) which evaluated the use of rituximab for the treatment of non-Hodgkin lymphoma (NHL) regarding its benefits, safety profile and cost-effectiveness. METHODS: A search of MEDLINE, Lilacs, Cochrane library, Web of science and INAHTA websites from 1990 to 2009 was conducted. The following MESH terms were used: "Meta-Analysis", "Systematic Reviews", "Lymphoma, Non-Hodgkin", "Lymphoma, Large B-Cell, Diffuse" and "rituximab". Included studies were those which evaluated the use of rituximab alone and/or in combination with other therapies in first line, second line and maintenance therapy for naive, refractory patients or relapsed disease in different patient characteristics. RESULTS: A total of six systematic reviews (SR) were found and met our inclusion criteria. For the indolent indication: a) Wake et al.2002 and Schulz et al.2007 evaluated the treatment as first line or subsequent therapies; b) Vidal et al.2009 and Aksoy et al.2009 assessed the maintenance therapy; c) Cheung et al.2007 evaluated: first line and subsequent therapies, maintenance and aggressive NHL; and d) Knight et al.2004 evaluated aggressive NHL. Only three studies developed a meta-analysis (Vidal, Schulz and Aksoy). According to the SRs rituximab induced remission, improved overall survival and disease control. Twenty five HTAR were found: 5 indicated the analysis through inexistent links; 2 belonged to sites with content blocked to non-members; 2 related to other drugs; 3 indicated ongoing analysis; 3 related to other indications. Consequently, 10 reports met the survey criteria. Seven out of 10 published HTAR support the use of rituximab for indolent or aggressive lymphomas. There are three assessments which are not conclusive. CONCLUSIONS: Findings from systematic reviews suggest that rituximab offer better clinical outcomes to patients. Most of the Health Technology Assessment reports indicate rituximab as a cost-effective alternative.
Conference/Value in Health Info
2009-10, ISPOR Europe 2009, Paris, France
Value in Health, Vol. 12, No. 7 (October 2009)
Code
PCN165
Topic
Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes
Disease
Oncology