A Comparison of the Clinical and Cost-Effectiveness of 3 Intervention Strategies for AIDS Wasting

摘要: OBJECTIVE To compare oxandrolone (OX) or strength training with nutrition alone (NA) for AIDS wasting. SUBJECTS Fifty patients AIDS; 47 completing the study. INTERVENTIONS Randomization to (1) NA placebo pills, (2) 10 mg of OX administered orally twice a day, (3) progressive resistance (PRT) 12 weeks. MAIN OUTCOME MEASURES Midthigh cross-sectional muscle area (CSMA), physical functioning (PF), costs, and cost-effectiveness in dollars/quality-adjusted life-years (dollars/QALYs). RESULTS The PRT subjects had increases CSMA (7.0% +/- 2.5%, P = 0.01; 5.0% 2.0%, 0.04, respectively), although these did not differ significantly from arm (NA: 1.0% 1.0%; vs. NA: 0.09; 0.26). Only caused significant improvements PF (mean SE: 10.4 3.8 points on 100-point scale) 7 measures (P values: 0.04 <0.001). There were no overall differences between groups change. Among impaired baseline PF, however, was less effective than better NA. All treatments led protein intake performance; also increased caloric intake. institutional costs per subject this trial 983 dollars NA, 3772 OX, 3189 PRT. At community-based level intensity, QALY 45,000 (range: 42,000 dollars-64,000 dollars) 147,000 dollars-163,000 31,000 21,000 dollars-44,000 CONCLUSIONS induce similar body composition, but improves quality life more particularly among PF. most cost-effective intervention, least intervention.