帕罗西汀对比度洛西汀治疗抑郁症的系统评价及药物经济学分析

Systematic evaluation and pharmacoeconomic analysis of Paroxetine versus Duloxetine in treatment of depression

目的给临床治疗抑郁症的药物选择提供循证依据并就经济性作出评价。方法检索建库至2020年3月中国知网、万方、维普、PubMed、EMBase、Cochrane library、SinoMed数据库。筛选帕罗西汀与度洛西汀治疗抑郁症的随机对照试验。使用RevMan 5.3软件进行meta分析,根据成本-效果比进行药物经济学分析。结果共纳入12篇RCT文献,共计1722例患者。meta分析结果显示,两组治疗总有效率比较,差异无统计学意义[RR=1.01,95%CI(0.96,1.07),P=0.65],两组治疗后汉密尔顿抑郁量表评分比较,差异有统计学意义[MD=0.71,95%CI(0.25,1.17),P=0.003],两组不良反应比较,差异有统计学意义[RR=1.11,95%CI(1.01,1.21),P=0.02],两组药物耐受性均较好。药物经济学方面,帕罗西汀成本-效果比为371.21,度洛西汀成本-效果比为536.11,增量成本-效果比为-28431.03。结论帕罗西汀与度洛西汀在治疗抑郁症上临床效果相当,帕罗西汀更易发生不良反应;帕罗西汀更具有经济学优势。

Objective To provide evidence-based evidence for the choice of drugs for clinical treatment of depression and to evaluate the economics.Methods CNKI,WanFang,VIP,PubMed,EMBase,Cochrane library and SinoMed were all searched.Randomized controlled trials of Paroxetine and Duloxetine in the treatment of depression were screened,the retrieval time was set up until March 2020.Meta-analysis and pharmacoeconomic analysis were performed using RevMan 5.3 software and cost-effectiveness ratio.Results A total of 12 RCT articles,1722 patients were included in the analysis.Meta-analysis results showed that there was no significant difference in the total effective rate between the two groups in treating depression(RR=1.01,95%CI[0.96,1.07],P=0.65),after treatment,there was a statistically significant difference in the score of hamilton depression scale between the two groups(MD=0.71,95%CI[0.25,1.17],P=0.003),and there was a statistically significant difference in the adverse reactions between the two groups(RR=1.11,95%CI[1.01,1.21],P=0.02),and both groups were well tolerated.In terms of pharmacoeconomics,the cost-effectiveness ratio of paroxetine was 371.21 and the duloxetine was 536.11,incremental cost-effectiveness ratio was-28431.03.Conclusion Paroxetine and Duloxetine have similar clinical effects in the treatment of depression,and paroxetine is more prone to adverse reactions,and paroxetine has economic advantages.