# Economische en QoL-uitkomsten van NT-proBNP-geleide HF-therapie

*geplaatst 2018-11-27 · Hartfalen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2018.08.2184 · https://hartvaat.nl/2018/11/27/economische-en-qol-uitkomsten-van-nt-probnp-geleide-hf-therapie/*

Economische en kwaliteit-van-leven analyse van NT-proBNP-geleide therapie bij hartfalen. Kosteneffectiviteitsperspectief naast de negatieve klinische resultaten.

## English: Economic and Quality-of-Life Outcomes of Natriuretic Peptide-Guided Therapy for Heart Failure.

This GUIDE-IT economic analysis showed that NT-proBNP-guided heart failure therapy does not improve cost-effectiveness compared with usual care, consistent with the neutral clinical primary endpoint.

## Abstract (original, from the publication)

BACKGROUND: The GUIDE-IT (GUIDing Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure) trial prospectively compared the efficacy of an N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided heart failure treatment strategy (target NT-proBNP level <1,000 pg/ml) with optimal medical therapy alone in high-risk patients with heart failure and reduced ejection fraction. When the study was stopped for futility, 894 patients had been enrolled. OBJECTIVES: The purpose of this study was to assess treatment-related quality-of-life (QOL) and economic outcomes in the GUIDE-IT trial. METHODS: The authors prospectively collected a battery of QOL instruments at baseline and 3, 6, 12, and 24 months post-randomization (collection rates 90% to 99% of those eligible). The principal pre-specified QOL measures were the Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary Score and the Duke Activity Status Index (DASI). Cost data were collected for 735 (97%) U.S. RESULTS: Baseline variables were well balanced in the 446 patients randomized to the NT-proBNP-guided therapy and 448 to usual care. Both the KCCQ and the DASI improved over the first 6 months, but no evidence was found for a strategy-related difference (mean difference [biomarker-guided - usual care] at 24 months of follow-up 2.0 for DASI [95% confidence interval (CI): -1.3 to 5.3] and 1.1 for KCCQ [95% CI: -3.7 to 5.9]). Total winsorized costs averaged $5,919 higher in the biomarker-guided strategy (95% CI: -$1,795, +$13,602) over 15-month median follow-up. CONCLUSIONS: A strategy of NT-proBNP-guided HF therapy had higher total costs and was not more effective than usual care in improving QOL outcomes in patients with heart failure and a reduced ejection fraction. (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment [GUIDE-IT]; NCT01685840).

Auteurs: Daniel B Mark, Patricia A Cowper, Kevin J Anstrom, Shubin Sheng, Melanie R Daniels, J David Knight, Khaula N Baloch, Linda Davidson-Ray, Mona Fiuzat, James L Januzzi, David J Whellan, Ileana L Piña, Justin A Ezekowitz, Kirkwood F Adams, Lawton S Cooper, Christopher M O'Connor, G Michael Felker

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2018.08.2184. Bijgewerkt 2026-07-03T13:26:50Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.