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Osteopathy: effectiveness and safety for musculoskeletal pain and overview of training and quality requirements
Osteopathy aims to holistically improve and support all aspects of health. Osteopathic treatments are often applied for pain in the musculoskeletal system. In Austria, there is no legal regulation for the practice, education and training of osteopaths, while other countries have already introduced regulations. The report aims to summarise evidence on the effectiveness and safety of osteopathy in the treatment of musculoskeletal pain and to provide an overview of the training and quality requirements and regulations for the osteopathic profession in Europe.
Publication: HTA Project Report No. 144: https://eprints.aihta.at/1416
Contact: Lucia Gassner
Covid-19: HSS/ Horizon Scanning Living Document (v24 October/November2022)
The establishment of a HSS/ Horizon Scanning System for Covid19 interventions has the intentions of informing health policy makers at an early stage which interventions (vaccinations and drugs) are currently undergoing clinical trials and to monitor them over the next few months in order to support evidence-based purchasing if necessary. The products are monitored with regard to the status of the clinical studies up to approval and finally evaluated for their benefit and harm.
All work steps are conducted in close international (European) cooperation.
Publications:
- Policy Brief No. 002: http://eprints.aihta.at/1234/
Contact: Claudia Wild
CAR-T cell therapy: Contrasting the evidence from pivotal trials with the real world evidence (RWE)
The two CAR-T cell therapies Kymriah® and Yescarta® were approved by the EMA in 2018 for patients with B-cell acute lymphoblastic leukaemia (B-ALL), diffuse large B-cell lymphoma (DLBCL) or primary mediastinal B-cell lymphoma (PMBCL) in third line. Treatment is often associated with high expectations, but the evidence on efficacy and safety of these novel therapies is still uncertain. The aim of this systematic review was to contrast the results of patient characteristics as well as selected efficacy and safety endpoints from the pivotal trials with those from real-world evidence studies. In addition, the results and conclusions of other HTA reports were summarised regarding the available evidence on efficacy and safety.
Publication: HTA Project Report No. 146: https://eprints.aihta.at/1415/
Contact: Claudia Wild
Horizon Scanning in Oncology - Fact Sheets
We are pleased to introduce our three new HSO Fact Sheets.
Fact Sheet No. 112 (November 2022)
Zanubrutinib (Brukinsa®) as monotherapy for the treatment of adult patients with chronic lymphocytic leukaemia (CLL)
Fact Sheet No. 113 (November 2022)
Cemiplimab (Libtayo®) as monotherapy for the treatment of recurrent or metastatic cervical cancer
Fact Sheet No. 114 (November 2022)
Lutetium (177Lu) vipivotide tetraxetan (Pluvicto®) in combination with androgen deprivation therapy (ADT) with or without androgen receptor (AR) pathway inhibition for the treatment of metastatic castration-resistant prostate cancer (mCRPC)
Horizon Scanning in Oncology - Fact Sheets
We are pleased to introduce our three new HSO Fact Sheets.
Fact Sheet No. 109 (October 2022)
Loncastuximab tesirine (Zynlonta®) as monotherapy for the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL)
Fact Sheet No. 110 (October 2022)
Zanubrutinib (Brukinsa®) as monotherapy for the treatment of marginal zone lymphoma (MZL)
Fact Sheet No. 111 (October 2022)
Axicabtagene ciloleucel (Yescarta®) for the treatment of patients with diffuse large B cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL)
Long COVID care pathways and structures: an updated scoping review
Long COVID can impact the patients' everyday functioning, including long absenteeism in school or work. As a result, the disease not only places a burden on patients and their families but also on the economy, especially the labour market. The present scoping review aimed to update the recommendations on care pathways for adult long COVID patients and add recommendations for children and adolescents. In addition, it presents further existing long COVID care structures of selected European countries.
Publication: HTA Project Report No. 135b Update: https://eprints.aihta.at/1408/
Contact: Sarah Wolf
Wearable cardioverter-defibrillator (WCD) therapy for primary and secondary prevention of sudden cardiac arrest. Update 2022
The wearable cardioverter defibrillator (WCD) is intended to provide protection against sudden cardiac death in high-risk patients. In 2018, the first RCT was available (VEST/ Prevention of Early Sudden Death Trial), showing no reduction in sudden cardiac death when compared to medical therapy alone. Due to the fact that VEST was limited by poor compliance, it is still unclear whether anticipated patient-relevant benefits of using the WCD is supported by scientific evidence.
The project at hand aimed at synthesising the current available evidence regarding the use of the WCD: An update systematic review regarding the effectiveness and safety of the WCD was performed. The best available RCT evidence still consists of VEST solely. Low certainty evidence derived from one RCT (n=2,348) indicated that WCD therapy might not be associated with a clinical benefit in arrhythmic mortality in post-myocardial infarction (MI) patients with an ejection fraction of ?35%.
Six new observational studies were identified, yielding to 11 observational studies meeting our inclusion criteria (range of enrolled patients: 102-2,000). New observational studies indicate that compliance with WCD is well above 20 hours per day, with poor compliance being a major limitation of the only available randomised evidence for WCD use. Most of the evidence is, however, observational and consists of studies including mixed-populations in the analysis, leading to the inability to draw firm conclusions on indication-specific utility of the WCD.
In the absence of comparative effectiveness evidence, more RCT data are needed to justify continuing or expanding the use of WCD therapy in Austria.
Publication: Decision Support Document No. 103/2. Update 2022: https://eprints.aihta.at/1407/
Contact: Gregor Götz
Covid-19: HSS/ Horizon Scanning Living Document (v23 August/September2022)
The establishment of a HSS/ Horizon Scanning System for Covid19 interventions has the intentions of informing health policy makers at an early stage which interventions (vaccinations and drugs) are currently undergoing clinical trials and to monitor them over the next few months in order to support evidence-based purchasing if necessary. The products are monitored with regard to the status of the clinical studies up to approval and finally evaluated for their benefit and harm.
All work steps are conducted in close international (European) cooperation.
Publications:
- Policy Brief No. 002: http://eprints.aihta.at/1234/
Contact: Claudia Wild
Horizon Scanning in Oncology - Fact Sheets
We are pleased to introduce our four new HSO Fact Sheets.
Fact Sheet No. 105 (August 2022)
Relatlimab/nivolumab (Opdualag®) for the first line treatment of advanced melanoma in adults and adolescents 12 years of age and older with tumour cell PD-L1 expression < 1%
Fact Sheet No. 106 (August 2022)
Fact Sheet No. 107 (August 2022)
Teclistamab (Tecvayli®) as monotherapy for the treatment of patients with relapsed and refractory multiple myeloma (MM) who have received at least three prior therapies
Fact Sheet No. 108 (August 2022)
Selpercatinib (Retsevmo®) as monotherapy for the treatment of adults and adolescents 12 years and older with advanced RET mutant medullary thyroid cancer (MTC)
Risk-based breast cancer screening in Austria: a systematic analysis of predictive models to assess individual breast cancer risk, their utility and applicability in a breast cancer screening program
Breast cancer screening programs aim to diagnose cancer earlier and reduce surgical therapies (e.g. mastectomy) or breast cancer deaths. However, screening (mammography) also carries risks, such as false-negative results or false-positive suspected breast cancer cases, which can result in unnecessary diagnostic procedures (biopsies) and therapies that are burdensome for patients. Risk-based screening considers multiple risk factors compared to traditional age-based breast cancer screening. Breast cancer should thus be detected equally well or earlier, and possible disadvantages of age-based screening should be reduced, for example, through risk-based screening recommendations – less frequent mammographies in women with a low risk of breast cancer. Against this background, the objective of this report was to investigate the risk prediction quality of identified risk prediction models and their effectiveness in a risk-based screening program. In addition, organisational requirements for implementing a risk-based screening program were summarised.
Publication: HTA Project Report No. 145: https://eprints.aihta.at/1402/
Contact: Ingrid Zechmeister-Koss
