托法替布治疗类风湿关节炎的快速卫生技术评估  

Health technology assessment of tofacitinib in the treatment of rheumatoid arthritis

作　　者：李若茗 解染 田欣 董秀 陈超阳[1,2] 马凌云 刘晓[1] 周颖[1,2] 崔一民[1,2] LI Ruo-ming;XIE Ran;TIAN Xin;DONG Xiu;CHEN Chao-yang;MA Ling-yun;LIU Xiao;ZHOU Ying;CUI Yi-min(Deparment of Pharmacy,Peking University First Hospital,Beijing 100034,China;Department of Pharmacy Administration and Clinical Pharmacy,School of Pharmaceutical Sciences,Peking University Health Science Center,Bejing 100191,China)

机构地区：[1]北京大学第一医院药学部,北京100034 [2]北京大学医学部药学院药事管理与临床药学系,北京100191

出　　处：《中国新药杂志》2021年第5期462-469,共8页Chinese Journal of New Drugs

摘　　要：目的:利用快速卫生技术评估(health technology assessment,HTA)的方法,定量地评价托法替布用于类风湿关节炎(RA)患者的有效性、安全性、经济性,针对托法替布在临床应用的实际情况,为临床实践、药物遴选和准入决策提供循证证据。方法:系统检索2019年5月31日前发表的HTA报告、系统评价/Meta分析和药物经济学研究,检索的数据库及网站包括HTA的各官方网站、英文数据库(PubMed和the Cochrane Library)、中文数据库如中国知网(CNKI)、万方和维普。结果:研究纳入HTA报告0篇,Meta分析21篇以及经济学研究3篇。结果显示托法替布单药或联合甲氨蝶呤治疗,可以明确地提高RA患者的ACR缓解率、健康评估问卷(HAQ)评分等疗效的指标,也没有增加严重感染等不良事件的发生率,并且托法替布可以更低的成本为患者带来更高的生活质量。结论:托法替布与生物制剂类药物的有效性与安全性相似,并且可以更好地节约成本,提高患者的用药依从性。Objective: To quantitatively evaluate the efficacy,safety,and economic characteristics of tofacitinib for the treatment of rheumatoid arthritis( RA) patients by using the method of health technology assessment( HTA) and to provide evidence for medication selection and decision making based on the actual application of tofacitinib in clinical practice. Methods: The HTA reports,systematic reviews/Meta analyses,and pharmacoeconomic researches published before May 31,2019 were systematically searched. The databases and websites we searched included HTA official websites,English databases( PubMed and the Cochrane Library),and Chinese databases such as China Knowledge Network( CNKI),Wanfang and Weipu. Results: No HTA reports,but 21 Meta-analyses and 3 economic studies were included in this study. The results show that tofacitinib alone or combined with methotrexate treatment can clearly improve the efficacy of ACR,HAQ scores and other indicators of patients with RA,while the incidence of adverse events such as severe infections did not significantly increase. It can bring higher quality of life to patients with lower cost. Conclusion: Tofacitinib and biologics are similar in efficacy and safety,and can improve patient medication compliance with a lower cost.

关 键 词：托法替布 类风湿关节炎 卫生技术评估 

分 类 号：R969.3[医药卫生—药理学]