5%咪喹莫特与0.5%鬼臼毒素治疗尖锐湿疣的成本-效果分析

Cost-effectiveness Analysis of 5% Imiquimod and 0.5% Podophyllotoxin in the Treatment of Condyloma Acuminatum

目的 :评价5 %咪喹莫特与0 5 %鬼臼毒素治疗尖锐湿疣的成本 -效果。方法 :收集1966年～2003年间有关咪喹莫特与鬼臼毒素治疗尖锐湿疣的随机双盲安慰剂对照临床研究文献 ,比较两种药物的临床疗效和不良反应 ,并作成本 -效果分析。结果 :咪喹莫特与鬼臼毒素治疗尖锐湿疣的治愈率分别为48 48 %、46 62 % ,无显著性差异 (P>0 05)。咪喹莫特最常见的不良反应为红斑、糜烂、瘙痒和表皮脱落、结痂、水肿 ;鬼臼毒素最常见的不良反应为灼热、炎症、糜烂、疼痛、瘙痒、出血。二者比较 ,鬼臼毒素不良反应发生率较高 ,也较严重。咪喹莫特与鬼臼毒素治疗尖锐湿疣的成本 -效果比分别为36 88、8 15。结论 :咪喹莫特与鬼臼毒素治疗尖锐湿疣具有相似的疗效 ,虽然鬼臼毒素成本 -效果比较低 ,但其不良反应却较多和较严重。

OBJECTIVE:To evaluate the cost-effectiveness ratios of5%imiquimod and0.5%podophyllotoxin in the treatment of condyloma acuminatum.METHODS:The reports on imiquimod and podophyllotoxin in the treatment of condyloˉma acuminatum with randomized,double-blind and placebo-controlled design,published from1966to2003,were collectˉed.The therapeutic effects and ADRs of two drugs were compared and conducted with cost-effectiveness analysis.RESULTS:The clinical cure rates of imiquimod and podophyllotoxin were48.48%and46.62%respectively with no statistically significant differences(P>0.05).The most common adverse reactions of imiquimod were erythema,erosion,itching,excoriation,scabbing and oedema,those of podophyllotoxin were burning sensation,inflammation,erosion,pain,itching and bleeding.The incidence of ADR of podophyllotoxin was higher.Cost-effectiveness analysis indicated that the C/E of imiquimod and podophyllotoxin was36.88and8.15respectively.CONCLUSION:Imiquimod and podophyllotoxin possessed similar curative effect on condyloˉma acuminatum,but the cost and C/E of podophyllotoxin were lower.At the same time,podophyllotoxin had more serious adˉverse reactions.