依替巴肽治疗急性冠脉综合征的卫生技术评估  

Eptifibatide in the Treatment of Acute Coronary Syndrome:Health Technology Assessment

作　　者：杨霞[1] 文程[1,2] 门鹏[1] 翟所迪[1] Yang Xia Wen Cheng Men Peng Zhai Suodi(Department of Pharmacy, Peking University Third Hospital, Beijing 100191 ,China Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University)

机构地区：[1]北京大学第三医院药剂科,北京100191 [2]北京大学药学院药事管理与临床药学系

出　　处：《药物流行病学杂志》2017年第8期513-520,共8页Chinese Journal of Pharmacoepidemiology

摘　　要：目的:明确依替巴肽临床使用的获益与风险,为临床治疗和决策者提供循证依据。方法:系统检索PubMed、Embase、The Cochrane Library、CNKI、CBM等数据库,以及国内外卫生技术品评估(HTA)机构官方网站。由2位评价者根据纳入与排除标准独立筛选文献、提取资料和评价质量后,对结果进行定性和定量分析。结果:共纳入3篇Meta分析、29篇随机对照研究(RCTs)和9篇经济学研究。依替巴肽与阿昔单抗和替罗非班等阳性对照药比较主要复合终点、全因死亡、心肌梗死、卒中、紧急血运重建等事件发生率方面的差异均无统计学意义(P>0.05)。与安慰剂相比能显著降低主要复合终点(RR=0.77,95%CI:0.65~0.90)、紧急血运重建事件(RR=0.74,95%CI:0.60~0.90)的发生率。与阿昔单抗和替罗非班相比,依替巴肽不增加大出血、血小板减少等发生率。与安慰剂、阿昔单抗、替罗非班相比,依替巴肽更具经济学优势。结论:依替巴肽用于急性冠脉综合征的治疗具有良好的有效性、安全性和经济性。Objective： Evaluating the effectiveness,safety and economy of eptifibatide in acute coronary syndrome patients using health technology assessment to provide evidence for clinical treatment and decision makers. Methods：PubMed,Embase,the Cochrane Library,CNKI and health technology assessment（ HTA） organization websites were systematically searched. Two reviewers independently identified studies,extracted data and assessed quality of included studies. Qualitative and quantitative analysis was performed. Results： 3 Meta-analyses,29 RCTs and 9 pharmacoeconomic studies were included. The incidence of composite outcome and urgent revascularization was significantly decreased in the eptifibatide group than that in the placebo group（ RR = 0. 77,95% CI： 0. 65-0. 90; RR = 0. 74,95% CI： 0. 60-0. 90）.While there was no significant difference in the incidence of composite outcome,all-cause moprtality,myocardial infarction,stroke and urgent revascularization between the eptifibatide and abciximab,tirofiban group（ P ﹥ 0. 05）. Eptifibatide did not increase the risk of major bleeding and thrombocytopenia compared with abciximab and tirofiban. Eptifibatide was more economical than placebo abciximab and tirofiban. Conclusion： Eptifibatide was an efficacious,safe choice for acute coronary syndrome treatment,and economieal.

关 键 词：依替巴肽 急性冠脉综合征 有效性 安全性 经济性 卫生技术评估 

分 类 号：R973.2[医药卫生—药品]