[關(guān)鍵詞]
[摘要]
目的 采用快速衛(wèi)生技術(shù)評估的方法綜合評估司美格魯肽周制劑與國內(nèi) 7個已上市的胰高血糖素樣肽-1受體激動劑 (GLP-1RA) 治療 2 型糖尿病的有效性、安全性與經(jīng)濟性差異。方法 通過計算機檢索 PubMed、Web of Science、Embase、the Cochrane Library、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫(CNKI)、萬方數(shù)據(jù)知識服務(wù)平臺、維普生物醫(yī)學(xué)數(shù)據(jù)庫(VIP)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(SinoMed)等數(shù)據(jù)庫,同時檢索國際衛(wèi)生技術(shù)評估機構(gòu)協(xié)作網(wǎng)、加拿大藥物衛(wèi)生技術(shù)局等衛(wèi)生技術(shù)評估機構(gòu)官方網(wǎng)站。根據(jù)納入與排除標(biāo)準(zhǔn)篩選文獻(xiàn)后,進(jìn)行文獻(xiàn)質(zhì)量評價并提取數(shù)據(jù),對有效性、安全性和經(jīng)濟性進(jìn)行分析和對比。結(jié)果 文獻(xiàn)篩選共納入20篇系統(tǒng)評價/Meta分析、6篇經(jīng)濟學(xué)研究。有效性方面,司美格魯肽周制劑在控制糖化血紅蛋白(HbA1c)、HbA1c<7%合格率、空腹血糖(FBG)和降低體質(zhì)量方面的療效相比其他GLP-1RA具有明顯優(yōu)勢。安全性方面,使用司美格魯肽周制劑引發(fā)部分胃腸道不良反應(yīng)的風(fēng)險高于其他GLP-1RA,發(fā)生心血管不良反應(yīng)和低血糖的風(fēng)險與其他 GLP-1RA無顯著性差異。經(jīng)濟性方面,在中國醫(yī)療保障體系內(nèi),使用司美格魯肽周制劑相比于其他 GLP-1RA是更具有經(jīng)濟性的治療方案。結(jié)論 司美格魯肽周制劑在有效性和經(jīng)濟性方面比其他GLP-1RA更具有優(yōu)勢,其安全性與其他GLP-1RA差異不大,但需要注意胃腸道不良反應(yīng)的發(fā)生。
[Key word]
[Abstract]
Objective Fast health and technology assessment has been adopted to evaluate effectiveness, safety and economy between semaglutide and the other 7 GLP-1RAs previously registered in China toward type 2 diabetes. Methods PUBMED, Web of Science, Embase, The Cochrane Library, CNKI, Wanfang, Vip and other databases were searched simultaneously and systematically to retrieve corresponding literature. The official website of the International Health Technology Evaluation Institutions, the Canadian Pharmaceutical Health Technology Bureau and other health technology assessment agencies were also been browsed, the literature was screened and filtered by eligible criteria. Results A total of 20 system evaluation/meta analysis and 6 economic research finally remained. In terms of effectiveness, the efficacy of semaglutide in controlling glycated hemoglobin (HBA1C), HBA1C < 7% qualification rate, fasting blood glucose (FPG), and lowering weight have obvious advantages compared to other GLP-1RAs. For safety aspect, the risk of semaglutide causing some gastrointestinal adverse reactions is higher than other GLP-1RAs, while the risk of adverse cardiovascular reactions and low blood sugar incidence was no difference to other GLP-1RAs. The economic assessment revealed that the use of semaglutide over other GLP-1RAs was a more economical therapy in the Chinese medical security system.Conclusion Semaglutide has an advantage in terms of effectiveness and economy than other GLP-1RAs. Its safety is not much different from other GLP-1RAs, while it is necessary to pay attention to the occurrence of adverse gastrointestinal reactions.
[中圖分類號]
R977
[基金項目]
中國醫(yī)藥教育協(xié)會課題(2023WSJSPGZXKT-01)