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Clinical and economic impact of Apligraf® for the treatment of nonhealing venous leg ulcers
Author(s) -
Fivenson David,
Scherschun Lubomira
Publication year - 2003
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2003.02039.x
Subject(s) - medicine , intensive care medicine , surgery , dermatology
Background Controlled studies have shown that Apligraf® (Organogenesis Inc., Canton, USA) is more economical and more effective at healing venous leg ulcers (VLUs) than compression therapy alone. However, the clinical and economic impact of Apligraf on healing VLUs in clinical practice has not been fully examined. Methods A medical chart review was conducted of patients who were treated with Apligraf for one or more nonhealing VLUs over a 2‐year period at the Henry Ford Hospital. Following Apligraf treatment, patients were followed for up to 9 months. Primary clinical outcome measures were mean change in baseline ulcer size (cm 2 ) per week and percent reduction in baseline ulcer size at final study visit. Economic evaluation of Apligraf treatment was based on VLU‐related medical care costs (US$) in relation to ulcer size (cm 2 ) changes before and after Apligraf therapy. Results Thirteen patients with 21 chronic VLUs were treated with Apligraf. All had at least one comorbidity, most commonly hypertension (38%). Twelve patients were known to have had a prior history of VLU. At baseline, mean ulcer duration was 23.9 months and median ulcer size was 13.5 cm 2 ; for the 6 months preceding Apligraf treatment, in which patients received conventional compression therapy, mean ulcer size increased +0.72 cm 2 per week. During the Apligraf post‐treatment study period, mean ulcer size decreased by −2.37 cm 2 per week. At final clinic visit, ulcers exhibited an average 60.5% reduction in baseline size; 21 ulcers ( n = 13) showed 75% or greater reduction in size, compared with baseline. Economic data were available for five patients; among these individuals ulcer‐related medical costs per unit change in ulcer size were lower following Apligraf treatment relative to such costs with conventional compression therapy applied during the Apligraf pretreatment period. Conclusions In a clinical practice setting, Apligraf is more effective and more economical at healing VLUs than conventional therapy alone.