PARI9: A UTILITY VALUATION STUDY ASSESSING TREATMENT OUTCOMES IN OSTEOARTHRITIS

Abstract

OA condition: The patient has an OA condition which is being managed with an NSAID. Clinical manifestations of OA can include pain, stiffness and physical disability. Usually, symptoms develop gradually and affect only one or a few joints at first. Joints of the fingers, base of the thumbs, neck, lower back, big toes, hips, and knees are commonly affected. GI side-effects: The patient in this health state has symptoms consistent with an NSAID type GI adverse event. The patient is experiencing one of the following NSAID type GI adverse events: acid reflux, heartburn, dyspepsia, epigastric discomfort, nausea or vomiting. Symptoms include burning pains, discomfort, belching and loud intestinal sounds. Other symptoms include a poor appetite, nausea, constipation, diarrhoea and flatulence. Health State C: Patient with OA; Managed with an NSAID; Experiencing an Uncomplicated PUB OA condition: The patient has an OA condition which is being managed with an NSAID. Clinical manifestations of OA can include pain, stiffness and physical disability. Usually, symptoms develop gradually and affect only one or a few joints at first. Joints of the fingers, base of the thumbs, neck, lower back, big toes, hips, and knees are commonly affected. GI side-effects: The patient in this health state has symptoms consistent with an uncomplicated PUB. Symptoms may include burning, gnawing, aching, soreness or hunger. The pain associated with symptoms is located in a well defined area and can be mild to moderately severe. The PUB is confirmed by endoscopy, surgery or radiographic results. The PUB is treated on an outpatient basis (potentially with proton pump inhibitors or H2-receptor antagonists). Health State D: Patient with OA; Managed with an NSAID; Experiencing a Complicated PUB OA condition: The patient has an OA condition which is being managed with an NSAID. Clinical manifestations of OA can include pain, stiffness and physical disability. Usually, symptoms develop gradually and affect only one or a few joints at first. Joints of the fingers, base of the thumbs, neck, lower back, big toes, hips, and knees are commonly affected. GI side-effects: The patient in this health state has symptoms consistent with a complicated PUB. Symptoms may include burning, gnawing, aching, soreness or hunger. The pain associated with symptoms is located in a well defined area and can be mild to moderately severe. The patient is hospitalised with a gastric or duodenal PUB confirmed by endoscopy, surgery or radiographic results. The confirmed ulcer has one or more of the following clinical features: Active bleeding on visible vessel; Clinically significant upper GI haemorrhage; Obstruction due to active duodenal or gastric ulcer. Depending on the clinical features of the PUB, patients will require different levels of intervention including watchful waiting, drug treatment, surgery and blood transfusion. Health State E: Patient with OA; Managed with paracetamol; Recovering from treatment for a PUB OA condition: The patient has an OA condition which is being managed with paracetamol. The patient has been withdrawn from NSAIDs due to previous GI complications. In this patient population, paracetamol may be less efficacious in the treatment of OA. Consequently, the patient’s OA symptoms may be worse than prior to the PUB. Clinical manifestations of OA can include pain, stiffness and physical disability. Usually, symptoms develop gradually and affect only one or a few joints at first. Joints of the fingers, base of the thumbs, neck, lower back, big toes, hips, and knees are commonly affected. GI side-effects: The patient is recovering from a successfully treated PUB. The patient has no GI complications. Health State A: Patient with OA; Managed with an NSAID; No GI complications OA condition: The patient has an OA condition which is being managed with an NSAID. Clinical manifestations of OA can include pain, stiffness and physical disability. Usually, symptoms develop gradually and affect only one or a few joints at first. Joints of the fingers, base of the thumbs, neck, lower back, big toes, hips, and knees are commonly affected. GI side-effects: The patient is NOT suffering from any GI complications.