度拉糖肽治疗2型糖尿病的快速卫生技术评估  

Rapid health technology assessment of dulaglutide for the treatment of type 2 diabetes mellitus

作　　者：姚媛[1] 苏芬丽[1] 孙旭[1] 冯时茵 熊芬[1] 蔡庆群[1] Yuan YAO;Fen-Li SU;Xu SUN;Shi-Yin FENG;Fen XIONG;Qing-Qun CAI(Department of Pharmacy The First Clinical School of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510400,China)

机构地区：[1]广州中医药大学第一附属医院药学部,广州510400

出　　处：《药物流行病学杂志》2023年第8期931-940,共10页Chinese Journal of Pharmacoepidemiology

基　　金：广东省医院药学研究基金项目(2019A26)。

摘　　要：目的 对度拉糖肽治疗2型糖尿病(T2DM)的有效性、安全性和经济性进行快速卫生技术评估,为临床治疗提供循证证据。方法 计算机检索PubMed、Embase、The Cochrane Library、CNKI、WanFang Data、VIP、SinoMed数据库及相关卫生技术评估(HTA)网站、数据库,搜集度拉糖肽治疗T2DM的高质量临床证据、药物经济学评价文献,检索时限均从建库至2023年3月31日。由2名研究者独立筛选文献、提取资料和评价纳入研究的质量后,对结果进行定性描述与分析。结果 共纳入22篇文献,其中HTA报告1篇,系统评价/Meta分析13篇,药物经济学研究8篇。有效性方面,度拉糖肽能有效降低T2DM患者的糖化血红蛋白和空腹血糖水平,提高糖化血红蛋白达标率,对体重影响优于磺脲类药物和胰岛素。安全性方面,度拉糖肽导致低血糖及胰腺炎发生风险较低,但胃肠道不良反应发生率明显增加,能降低心血管不良事件及卒中发生,无心脑血管不良影响。经济学研究显示,国内外研究提示度拉糖肽具有一定的成本-效用优势,但目前国内经济学研究数据有限。结论 度拉糖肽治疗T2DM具有一定的有效性和安全性,需进一步开展该药在国内的经济学评价以评估其经济性。Objective To evaluate the efficacy,safety and economics of dulaglutide in the treatment of type 2 diabetes mellitus(T2DM)by rapid health technology assessment,and to provide the evidence-based medical evidence to clinic.Methods PubMed,Embase,The Cochrane Library,CNKI,WanFang Data,VIP and the related health technology assessment(HTA)websites and databases were electronically searched to collect high-quality clinical evidence and pharmacoeconomics evaluation literature of dulaglutide in the treatment of T2DM from their inception dates to March 31st,2023.Two reviewers independently screened literature,extracted data,accessed the quality of included studies and qualitatively described and analyzed the results.Results A total of 22 studies were included,including 1 HTA report,13 systematic review/Meta-analyses and 8 pharmacoeconomics researches.The result of efficacy showed that dulaglutide could lower the level of HbAlc and fasting blood glucose,and improve the success rate of HbAlc in patients with T2DM,had a better impact on body weight than sulfonylureas and insulin.In terms of safety,the risk of hypoglycemia and pancreatitis caused by dulaglutide was low,but the incidence of gastrointestinal adverse reactions was significantly increased,it could reduce the incidence of cardiovascular adverse events and strokes,and had no cardiovascular or cerebrovascular adverse effects.The economic evaluation results showed that dulaglutide was a cost-effective treatment,but the research of cost-effectiveness analysis of dulaglutide was limited in China.Conclusion Dulaglutide has been shown to be effective and safe in the treatment of T2DM.It's necessary to carry out the economics research of dulaglutide in China.

关 键 词：度拉糖肽 2型糖尿病 快速卫生技术评估 

分 类 号：R587.1[医药卫生—内分泌]