盐酸阿罗洛尔治疗原发性高血压的临床综合评价  

Comprehensive clinical evaluation of arotinolol hydrochloride in the treatment of essential hypertension

作　　者：刘春平 高晶磊 赵昕锐 简怡飞 黄其翔 赵琨 LIU Chunping;GAO Jinglei;ZHAO Xinrui;JIAN Yifei;HUANG Qixiang;ZHAO Kun(China National Health Development Research Center,Beijing,100044,China;National Center for Medicine and Health Technology Assessment;School of International Pharmaceutical Business,China Pharmaceutical University;Health Economic Research Institute,School of Pharmacy Sciences,Sun Yat-Sen University)

机构地区：[1]国家卫生健康委卫生发展研究中心,北京100044 [2]国家药物和卫生技术综合评估中心 [3]中国药科大学国际医药商学院 [4]中山大学药学院医药经济研究所

出　　处：《中华高血压杂志》2023年第8期741-750,共10页Chinese Journal of Hypertension

摘　　要：目的 开展针对β受体阻滞剂盐酸阿罗洛尔(阿罗洛尔)的临床综合评价,分析其用于原发性高血压的临床综合价值,并与酒石酸美托洛尔(美托洛尔)进行比较,为临床用药选择提供参考。方法 2021年,通过文献研究(荟萃分析)、一手数据分析、药物经济学模型、问卷调查等方法,分析比较阿罗洛尔和美托洛尔的安全性、有效性、经济性、适宜性,并对阿罗洛尔的可及性进行分析。结果 相比于美托洛尔,阿罗洛尔治疗原发性高血压总有效率更高(OR=2.03,95%CI 1.08~3.81,P=0.03),舒张压降幅更优[均数差=3.06(95%CI 0.62~5.50)mmHg,P=0.01],相对安全性更好,不良反应发生率相对更低,且在2020年中国1倍人均国内生产总值(GDP,72 447元)的阈值下更具有成本效果优势[增量成本效果比(ICER)=14 519.19元/质量调整生命年(QALYs)]。阿罗洛尔的口味更佳、给药途径的适宜性良好,总体评价更优。可及性分析显示阿罗洛尔的药价设置处在合理范围,长期服用不易导致家庭贫困,医疗机构的可获得率正在改善。结论 相比于美托洛尔,属于第三代β受体阻滞剂的阿罗洛尔的临床综合价值更高。Objective To conduct a comprehensive clinical evaluation of the beta-blocker drug arotinolol hydrochloride(arotinolol),analyze its comprehensive clinical value in essential hypertension and compare with metoprolol tartrate(metoprolol)to provide reference for clinical rational use.Methods In 2021,literature research(meta-analysis),primary data analysis,pharmacoeconomic model,questionnaire and other methods were used to compare the safety,efficacy,economy and suitability of arotinolol and metoprolol,and the accessibility of arotinolol was analyzed.Results Compared with metoprolol,arotinolol had a higher overall efficiency rate(OR=2.03,95%CI 1.08 to 3.81,P=0.03),better diastolic blood pressure reduction[mean difference(MD)=3.06(95%CI 0.62 to 5.50)mmHg,P=0.01],relative lower incidence of adverse events and more safety,and it was more cost-effective at the decision thresholds of 1 times the Chinese per capita gross domestic product in 2020(72447 yuan)[incremental cost effectiveness ratio(ICER)=14519.19 yuan/quality-adjusted life-years(QALYs)].Arotinolol had better taste,good route of administration suitability,and better overall evaluation.The accessibility analysis showed that the price of arotinolol was set in a reasonable range,that long-term use was less likely to lead to household poverty,and the accessibility to healthcare facilities was improving.Conclusion Compared with metoprolol,the third-generation beta-blocker arotinolol has a higher comprehensive clinical value.

关 键 词：盐酸阿罗洛尔 酒石酸美托洛尔 原发性高血压 临床综合评价 

分 类 号：R544.11[医药卫生—心血管疾病]