[vc_empty_space][vc_empty_space]
Markov modeling for microvascular renal complication of niddm and hypertension to evaluate the use of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB)
Hidayat Y.A.a, Padmasawitri T.I.A.a, Sigit J.I.a
a Research Group on Industrial System and Techno-Economics, Faculty of Industrial Technology, Institut Teknologi Bandung, Indonesia
[vc_row][vc_column][vc_row_inner][vc_column_inner][vc_separator css=”.vc_custom_1624529070653{padding-top: 30px !important;padding-bottom: 30px !important;}”][/vc_column_inner][/vc_row_inner][vc_row_inner layout=”boxed”][vc_column_inner width=”3/4″ css=”.vc_custom_1624695412187{border-right-width: 1px !important;border-right-color: #dddddd !important;border-right-style: solid !important;border-radius: 1px !important;}”][vc_empty_space][megatron_heading title=”Abstract” size=”size-sm” text_align=”text-left”][vc_column_text]In the case of chronic disease, randomized clinical trial (RCT) can only provide partial information due to the limitation of observation time. Markov Model is able to accommodate the need of RCT data extrapolation beyond the observation time. In this study, we utilize a Markov Model to investigate two drugs i.e. Angiotensin Converting Enzyme Inhibitor (ACEI) and Angiotensin Receptor Blocker (ARB), for the management of microvascular renal complication of Non- Insulin Dependent Diabetes Mellitus (NIDDM) and Hypertension. We obtain data from previous meta-analysis study of several RCTs. We divide renal complications into four Markov states which represent the albuminuria level. Medication with ACEI and ARB are the treatment decision options. The result shows that ACEI and ARB are effective in halting the progression of renal complication until cycle 9 or 32 years prior to drug treatment initiation. It also shows that, ACEI is more effective when it is used in earlier years (up to 17.5 years), but becomes less effective compared to ARB when the drug treatment is prolonged. A sensitivity analysis is performed and shows that the drug price and the initial disease prevalence influence the model significantly.[/vc_column_text][vc_empty_space][vc_separator css=”.vc_custom_1624528584150{padding-top: 25px !important;padding-bottom: 25px !important;}”][vc_empty_space][megatron_heading title=”Author keywords” size=”size-sm” text_align=”text-left”][vc_column_text]ACEI,Angiotensin converting enzyme inhibitors,ARB,Insulin-dependent diabetes mellitus,Markov model,Partial information,Randomized clinical trials,Renal complication[/vc_column_text][vc_empty_space][vc_separator css=”.vc_custom_1624528584150{padding-top: 25px !important;padding-bottom: 25px !important;}”][vc_empty_space][megatron_heading title=”Indexed keywords” size=”size-sm” text_align=”text-left”][vc_column_text]ACEI,ARB,Markov model,Renal complication[/vc_column_text][vc_empty_space][vc_separator css=”.vc_custom_1624528584150{padding-top: 25px !important;padding-bottom: 25px !important;}”][vc_empty_space][megatron_heading title=”Funding details” size=”size-sm” text_align=”text-left”][vc_column_text][/vc_column_text][vc_empty_space][vc_separator css=”.vc_custom_1624528584150{padding-top: 25px !important;padding-bottom: 25px !important;}”][vc_empty_space][megatron_heading title=”DOI” size=”size-sm” text_align=”text-left”][vc_column_text][/vc_column_text][/vc_column_inner][vc_column_inner width=”1/4″][vc_column_text]Widget Plumx[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row][vc_column][vc_separator css=”.vc_custom_1624528584150{padding-top: 25px !important;padding-bottom: 25px !important;}”][/vc_column][/vc_row]