国家科技部中国科技论文统计源期刊   中国科技核心期刊   WHO西太平洋地区医学索引(WPRIM)收录期刊   湖北优秀期刊
《药物流行病学杂志》官方网站与投审稿系统变更通知<点击查看详情>
替格瑞洛用于急性冠脉综合征的卫生技术评估
Ticagrelor in the Treatment of Acute Coronary Syndrome: Health Technology Assessment
  
DOI:
中文关键词:  急性冠脉综合征  替格瑞洛  卫生技术评估  系统评价
英文关键词:Acute coronary syndrome  Ticagrelor  Health technology assessment  Systematic review
基金项目:
作者单位
董淑杰 刘啸 宋再伟①② 翟所迪 ①北京大学第三医院药剂科(北京 100191)②北京大学药学院 
摘要点击次数: 1622
全文下载次数: 1145
中文摘要:
      摘 要 目的:评估新型血小板P2Y12受体抑制药替格瑞洛治疗急性冠脉综合征(ACS)的有效性、安全性和经济性,为临床用药和决策提供证据支持。方法:计算机检索PubMed、Embase、the Cochrane Library、Web of Science、CNKI和SinoMed等数据库,按照纳入排除标准筛选已发表的HTA报告、系统评价/Meta分析、RCT、药物经济学分析,并评价其研究质量。对RCT研究结果进行Meta分析,对其他研究结果进行定性分析。结果:在有效性上,与氯吡格雷相比,替格瑞洛可显著降低主要心脏不良事件的发生率(RR=0.86,95%CI:0.79~0.94,P=0.000 4)、心血管死亡率(RR=0.77,95%CI:0.68~0.88,P<0.000 1)、全因死亡率(RR=0.81,95%CI:0.71~0.91,P=0.000 8)、心肌梗死发生率(RR=0.82,95%CI:0.73~0.91,P=0.000 2)、支架内血栓发生率(RR=0.74,95%CI:0.61~0.91,P=0.004)。在安全性上,与氯吡格雷相比,替格瑞洛对主要出血发生率(RR=1.04,95%CI:0.96~1.13,P=0.30)和心动过缓发生率(RR=1.12,95%CI:0.98~1.28,P=0.08)无明显影响,但增加了主要或次要出血的发生率(RR=1.28,95%CI:1.04~1.58,P=0.02)和呼吸困难的发生率(RR=1.76,95%CI:1.62~1.91,P<0.000 01)。在经济性上,替格瑞洛比氯吡格雷和基因检测指导的抗血小板治疗更具有经济性。结论:替格瑞洛用于ACS具有有效性、安全性和经济性。
英文摘要:
      ABSTRACT Objective:To support clinical practice and decision making by evaluating the efficacy, safety and economic efficiency of new platelet inhibition regimens targeting P2Y12 receptors ticagrelor in patients with acute coronary syndrome (ACS). Methods: Database such as PubMed, Embase, the Cochrane Library, Web of Science, CNKI and SinoMed were searched to collect HTA reports, systematic reviews/meta analyses, RCTs and pharmacoeconomic studies. Results:In regard to efficacy outcomes, compared with clopidogrel, ticagrelor reduced the incidence of major adverse cardiovascular events (RR=0.86,95%CI:0.79 0.94,P=0.000 4), cardiovascular deaths (RR=0.77,95%CI:0.68 0.88,P<0.000 1), all cause mortality (RR=0.81,95%CI:0.71 0.91,P=0.000 8), myocardial infarction (RR=0.82,95%CI:0.73 0.91,P=0.000 2), stent thrombosis (RR=0.74,95%CI:0.61 0.91,P=0.004). In regard to safety outcomes, ticagrelor didn’t increase the incidence of major bleeding (RR=1.04,95%CI:0.96 1.13,P=0.30) and bradycardia (RR=1.12,95%CI:0.98 1.28,P=0.08), while it increased the incidence of major/minor bleeding (RR=1.28,95%CI:1.04 1.58,P=0.02) and dyspnea (RR=1.76,95%CI:1.62 1.91,P<0.000 01). In regard to economic efficiency, ticagrelor was cost effectiveness compared to clopidogrel and genotype driven antiplatelet therapy.Conclusion:Ticagrelor had favorable profiles in efficacy, safety and economical efficiency in the treatment of ACS.
查看全文  查看/发表评论  下载PDF阅读器
关闭