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Clinical and economic impact of Apligraf® for the treatment of nonhealing venous leg ulcers
Abstract
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.
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“Medical costs per unit change in ulcer size were lower following Apligraf treatment relative to cost of the control group (Fivenson and Scherschun 2003).”
From A review of a bi-layered living cell treatment (Apligraf) in the treatment of venous leg ulcers and diabetic foot ulcers (2007) · cites this paper as Fivenson and Scherschun 2003
In the citing paper
“Controlled clinical studies have shown that Apligraf is more effective and economical at healing chronic VLU (Schonfeld et al 2000; Curran and Plosker 2002; Fivenson and Scherschun 2003) and DFU (Veves et al 2001; Redekop et al 2003) than standard wound care therapy alone.”
From A review of a bi-layered living cell treatment (Apligraf) in the treatment of venous leg ulcers and diabetic foot ulcers (2007) · cites this paper as Fivenson and Scherschun 2003
In the citing paper
“Another study comparing patients with chronic non-healing VLU (mean duration of ulceration upon entering study was 23.9 months and median ulcers size of 13.5 cm2) treated with standard compression therapy or Apligraf reported a 0.72 cm2 increase in mean ulcer size per week in the control group, while the Apligraf-treated group had an average decrease of 2.37 cm2 per week.”
From A review of a bi-layered living cell treatment (Apligraf) in the treatment of venous leg ulcers and diabetic foot ulcers (2007) · cites this paper as Fivenson and Scherschun 2003
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Cited by
Human skin wounds: A major and snowballing threat to public health and the economy
Sen, C. K., Gordillo, G. M., Roy, S., Kirsner, R., Lambert, L., Hunt, T. K., Gottrup, F., Gurtner, G. C., & Longaker, M. T. (2009) · Wound Repair and Regeneration · doi:10.1111/j.1524-475x.2009.00543.x · Cited by 2,965
Zaulyanov, L., & Kirsner, R. S. (2007) · Clinical Interventions in Aging · doi:10.2147/ciia.2007.2.1.93 · Cited by 266
Metadata
- Authors
- Fivenson, D., & Scherschun, L.
- Venue
- International Journal of Dermatology
- Publisher
- Wiley
- Published
- 2003-11-25
- Volume
- 42
- Issue
- 12
- Pages
- 960-965
- ISSN
- 0011-9059
- 1365-4632
- Cited by
- 27
- References
- 0
- Language
- en
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- Fivenson, D., & Scherschun, L. (2003). Clinical and economic impact of Apligraf® for the treatment of nonhealing venous leg ulcers. International Journal of Dermatology. https://doi.org/10.1111/j.1365-4632.2003.02039.x
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