伏硫西汀治疗抑郁症的快速卫生技术评估  

Vortioxetine for the treatment of major depressive disorder:a rapid health technology assessment

作　　者：陈诗狄 李静[1] 门鹏[2] 刘永珍[3] 刘芳 CHEN Shi-di;LI Jing;MEN Peng;LIU Yong-zhen;LIU Fang(Department of Pharmacy,Beijing Haidian Hospital,Beijing 100080,China;Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Department of Neurology,Beijing Haidian Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀医院药剂科,北京100080 [2]北京大学第三医院药剂科,北京100191 [3]北京市海淀医院神经内科,北京100080

出　　处：《临床药物治疗杂志》2024年第4期26-31,共6页Clinical Medication Journal

摘　　要：目的通过快速卫生技术评估(HTA),评价伏硫西汀治疗抑郁症的有效性、安全性和经济性,为临床用药及卫生决策提供循证参考。方法系统检索PubMed、Embase、the Cochrane Library、中国知网、万方数据知识服务平台、中国生物医学文献服务系统等数据库及HTA相关网站,由2名研究者独立进行文献筛选、数据提取和质量评价,并对结果进行定性分析。结果共纳入28篇文献,包括3篇HTA报告、19篇系统评价/meta分析和6篇药物经济学研究,文献质量总体良好。与安慰剂相比,伏硫西汀治疗可提高抑郁症患者的有效率与治愈率,降低抑郁症状及认知功能相关量表评分,与其他抗抑郁药如选择性5-羟色胺再摄取抑制剂、5-羟色胺去甲肾上腺素再摄取抑制剂、阿戈美拉汀等的有效性相当。伏硫西汀不良反应总发生率低,主要为恶心等消化道症状。对初始1种或2种抗抑郁药疗效不佳的抑郁症患者,转换治疗选择伏硫西汀更具成本-效果。结论伏硫西汀具有良好的有效性和安全性,但成本较高,用于抑郁症二线或三线治疗更具经济学优势。Objective To evaluate the efficacy,safety and economy of vortioxetine in the treatment of major depressive disorder based on rapid health technology assessment(HTA),providing reference for clinical medication and health policy de⁃cisions.Methods PubMed,Embase,the Cochrane Library,CNKI,Wanfang Data,SinoMed,and HTA institutions were sys⁃tematically retrieved.Two researchers independently screened the literature,extracted data,evaluated quality,and performed descriptive analysis.Results Totally 28 studies involving 3 HTA reports,19 systematic review/meta analyses and 6 pharmaco⁃economic evaluations were finally included,qualities of which were medium or high.Compared with placebo,vortioxetine improved response rate and remission rate,and reduced depressive symptoms and cognitive function-related scale scores.Vor⁃tioxetine had no difference in efficacy compared with selective serotonin reuptake inhibitors,serotonin-norepinephrine reup⁃take inhibitors,and agomelatine.The overall adverse reaction incidence of vortioxetine was low,mainly including gastrointes⁃tinal symptoms such as nausea.For major depressive disorder patients who had responded inadequately to one or two antide⁃pressants,choosing vortioxetine as a switch therapy was more cost-effective.Conclusion Vortioxetine has good efficacy,and safety but higher cost,which is more cost-effective for second-line or third-line treatment of major depressive disorder.

关 键 词：伏硫西汀 抑郁症 卫生技术评估 

分 类 号：R971.4[医药卫生—药品] R749.4[医药卫生—药学]