Renal denervation given the thumbs up by researchers

Sep 17 2012

By Piriya Mahendra, medwireNews Reporter

Catheter-based renal denervation is a cost-effective strategy for resistant hypertension that may result in lower cardiovascular morbidity and mortality, a modeling prediction suggests.

"Our results indicate that renal denervation might be cost-effective when compared to other, well-accepted medical treatments with an incremental cost-effectiveness ratio that is markedly below the commonly accepted threshold of US$ 50,000 (€ 38,390) per quality-adjusted life-year (QALY)," say Benjamin Geisler (Wing Tech Inc, California, USA) and team.

They found that renal denervation was predicted to substantially reduce the 10-year risks for stroke by 30%, myocardial infarction (MI) by 32%, all coronary heart disease by 22%, heart failure by 21%, and end-stage renal disease by 28% compared with standard of care.

In addition, the corresponding predicted reductions in lifetime stroke, MI, coronary heart disease, heart failure, and end-stage renal disease were 17%, 15%, 10%, 8%, and 19%, the authors report in the Journal of the American College of Cardiology.

The authors explain that the lower decreases in lifetime risk compared with 10-year risk "might reflect the late in-life contribution of events that were delayed [by the intervention] but not fully prevented," the researchers write.

The median duration of survival with renal denervation was 18.4 years compared with 17.1 years in those who received standard of care.

The study also showed that the discounted lifetime incremental cost-effectiveness ratio was US$ 3071 (€ 2345) per QALY.

The researchers based their patient characteristics on those in the Simplicity Hypertension-2 trial, which showed that catheter-based renal denervation lowered the mean systolic blood pressure by 32 mmHg from 128 mmHg at baseline.

The authors warn that as their model was based mainly on a Caucasian population, certain modeling assumptions might not reflect the full spectrum of possible disease progression.

"Although renal denervation therapy represents an additional cost at time of treatment, it seems to offer great value over time," Geisler and team conclude.

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