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Original

Cost-effectiveness analysis of mecapegfilgrastim and recombinant human granulocyte stimulating factor for primary prophylaxis of chemotherapy-induced neutropenia in non-small cell lung cancer 

Yong-Li Gu, Zeng-Xian Sun, Ying Sun, Xin Guan, and Dao-Li Jiang

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Volume 62 (2024) p. 115 - 121

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 62 – No. 3/2024 (115-121)

Cost-effectiveness analysis of mecapegfilgrastim and recombinant human granulocyte stimulating factor for primary prophylaxis of chemotherapy-induced neutropenia in non-small cell lung cancer 

Yong-Li Gu¹, Zeng-Xian Sun¹, Ying Sun¹, Xin Guan², and Dao-Li Jiang³

¹Department of Pharmacy, The First People’s Hospital of Lianyungang, Lianyungang, ²School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, and ³Department of Pharmacy, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Objective: To evaluate the efficacy, safety, and economics of mecapegfilgrastim and recombinant human granulocyte colony-stimulating factor (rhG-CSF) in the primary prevention of chemotherapy-related neutropenia in non-small cell lung cancer (NSCLC).
Materials and methods: Data from 181 patients with NSCLC who received intermediate risk chemotherapy were collected from the information system of a tertiary hospital in China. Patients were categorized into two groups: those treated with mecapegfilgrastim (n = 91) and those treated with rhG-CSF (n = 90). The clinical efficacy rates of neutropenia prevention were used as effect indicators, and a cost-effectiveness analysis was conducted from the perspective of the Chinese healthcare system. Logistic regression, generalized linear regression, and bootstrap methods were used for sensitivity analyses.
Results: There was no statistical difference between the mecapegfilgrastim and rhG-CSF groups in clinical efficacy rates (98.9 vs. 97.8%). However, the total cost in the mecapegfilgrastim group was significantly higher than that in the rhG-CSF group (16,341.6 CNY vs. 14,371.1 CNY, p = 0.03). The cost-minimization analysis shows that mecapegfilgrastim is not cost-effective. The sensitivity analyses confirm that these results are robust.
Conclusion: Compared with rhG-CSF, mecapegfilgrastim is not a cost-effective strategy for NSCLC patients in neutropenia prevention in China.Correspondence to:
Dao-Li Jiang, MSc, Clinical pharmacist
Department of Pharmacy
The Affiliated Hospital of Xuzhou Medical University
Xuzhou, Jiangsu 221002, China
Email: [email protected]

Letter to the Editor

A case of lipoprotein glomerulopathy complicated with IgA nephropathy

Jiajun Wu and Xian Sun

Volume 104 (2025) p. 446 - 448

Neph rology Education

Fibronectin glomerulopathy caused by genetic FN1 mutation: A case report and literature review 

Bairu Shi, Yang Xia, Kejia Li, Long Jin, Xian Sun, and Hui Yu

Volume 105 (2026) p. 352 - 359

Abstract

Clinical Nephrology, Vol. 105 – No. 5/2026 (352-359)

Fibronectin glomerulopathy caused by genetic FN1 mutation: A case report and literature review 

Bairu Shi¹#², Yang Xia¹#², Kejia Li¹#², Long Jin¹#², Xian Sun¹#², and Hui Yu³#⁴

¹Department of Nephrology, The First People’s Hospital of Jiashan, Jiaxing City, Zhejiang Province, ²Department of Nephrology, Jiashan Branch of the Second Affiliated Hospital of Medical College Zhejiang University, Jiaxing, ³Department of Orthopedics Surgery, The First People’s Hospital of Jiashan, Jiaxing City, Zhejiang Province, and ⁴Department of Orthopedics Surgery, Jiashan Branch of the Second Affiliated Hospital of Medical College Zhejiang University, Jiaxing, China
Background: Fibronectin glomerulopathy (FGP), also known as fibronectin deposition glomerulopathy (GFND), is a rare hereditary autosomal dominant glomerular disease. Its clinical manifestations are proteinuria, hematuria, hypertension, and hyperkalemic distal renal tubular acidosis, which often progresses slowly to end-stage renal disease.
Case description: We report a 21-year-old woman with fibronectin glomerulopathy who underwent renal puncture at the age of 10. The pathology was considered to be thrombotic microangiopathy, and it was not treated regularly. This time, renal puncture was performed again due to proteinuria combined with elevated serum creatinine. Light microscopy showed severe mesangial matrix hyperplasia of glomeruli with dense deposition and foam cell aggregation in capillary loops. Fibrinogen immunostaining was positive. Electron microscope showed severe hyperplasia of mesangial matrix, and a large amount of electron-dense matter deposited in mesangial area. Perfect genetic testing suggested that the FN1 gene was heterozygous for NM_212482.4 (c.2918A>G), that is, Y973C mutation. Therefore, she was diagnosed with fibronectin glomerulopathy and was given sacubitril valsartan sodium tablets 200 mg b.i.d. orally.
Conclusion: We report a case of a patient with fibronectin glomerulopathy and review the literature of this disease. The disease often has insidious onset, and fibronectin deposition is a typical pathological change that can result. The disease slowly progresses to end-stage renal disease. At present, there is no specific treatment. It is advocated to use reninangiotensin-aldosterone system blockers to strictly control blood pressure and proteinuria, and the overall prognosis is poor. Genetic testing techniques may be helpful in early diagnosis of the disease.Correspondence to:
Dr. Hui Yu
Department of Orthopedics Surgery
The First People’s Hospital of Jiashan
or
Department of Orthopedics Surgery
Jiashan Branch of the Second Affiliated
Hospital of Medical College Zhejiang University
1218 South Sports Road
Jiaxing City, PR China
Email: [email protected]

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