伊布替尼治疗CLL/SLL、MCL的快速卫生技术评估

Ibrutinib in the Treatment of CLL/SLL,MCL:Rapid Health Technology Assessment

目的明确伊布替尼治疗慢性淋巴细胞白血病(chronic lymphocytic leukemia, CLL)/小淋巴细胞淋巴瘤(small lymphotic lymphoma, SLL)、套细胞淋巴瘤(mantle cell lymphoma, MCL)的有效性、安全性和经济性,为临床治疗提供循证依据。方法按照纳入排除标准,全面检索并筛选卫生技术评估(HTA)报告、系统评价/Meta分析、经济学研究,并对纳入文献进行综合分析。结果快速评估最终纳入系统评价/Meta分析6篇,经济学研究4篇。伊布替尼对MCL、CLL/SLL患者的无进展生存期(PFS)、总生存时间(OS)与对照组相比延长,差异有统计学意义。伊布替尼的主要不良反应有出血、房颤、感染、骨髓抑制等,其不良反应发生率与对照组相比升高,差异有统计学意义。结论伊布替尼可显著延长MCL、CLL/SLL患者的PFS和OS,但相关不良反应发生率会有所上升,临床应密切关注相关用药不良事件并及时进行对症处理。

OBJECTIVE To evaluate the efficacy, safety and economy of ibrutinib in the treatment of CLL/SLL and MCL, and to provide evidence-based basis for clinical treatment. METHODS HTA reports and systematic reviews/Meta analyses were retrieved and screened following defined inclusion and exclusion criteria.And conduct a comprehensive analysis of the included literature. RESULTS 6 systematic reviews/Meta analyses and 4 economics research were finally included in the rapid assessment.Compared with control group, ibrutinib could sighificantly prolong progression free survival(PFS) and overall survival(OS) with CLL/SLL, MCL patient.The main adverse reactions of ibrutinib include bleeding, atrial fibrillation, infection, myelosuppression, etc.Compared with control group, ibrutinib could rose adverse effects rate. CONCLUSION Ibrutinib could sighificantly prolong PFS and OS with CLL/SLL, MCL patient.But the incidence of related adverse reactions will increase.Clinicians should attention to the adverse events related to medication and promptly carry out symptomatic treatment.