吡格列酮二甲双胍治疗2型糖尿病的快速卫生技术评估

Rapid health technology assessment of pioglitazone metformin in treatment of type 2 diabetes mellitus

目的:基于快速卫生技术评估方法,评价吡格列酮二甲双胍复方制剂治疗2型糖尿病的有效性、安全性和经济性。方法:检索PubMed、Embase、the Cochrane Library、Web of Science、中国知网、万方等数据库,同时检索相关快速卫生技术评估(HTA)网站及数据库。根据纳入与排除标准独立筛选文献、评价质量和提取数据后,对其有效性、安全性和经济性结果进行定性分析。结果:共纳入0篇HTA报告、11篇系统评价/Meta分析、8篇经济学研究。结果显示,吡格列酮联合二甲双胍能有效降低2型糖尿病患者糖化血红蛋白水平,不良反应发生率无显著增加,低血糖发生风险较低;二者的复方制剂与两药联用相比,可提高患者用药依从性;在经济性方面,吡格列酮联合二甲双胍可延长患者的质量调整生命年(QALYs),具有较好的成本效果,复方制剂与之相比未增加费用。结论:吡格列酮联合二甲双胍治疗2型糖尿病具有较好的安全性、有效性和经济性。

Objective:The rapid health technology assessment(HTA)was used to evaluate the efficacy,safety and economics of pioglitazone metformin compound preparation for type 2 diabetes mellitus.Methods:Literature were searched in databases of PubMed,Embase,the Cochrane Library,Web of Science,CNKI,Wanfang,etc.After independently screening the literature,evaluating the quality and extracting the data according to the inclusion and exclusion criteria,the effectiveness,safety and economic results were analyzed qualitatively.Results:A total of 0 HTA report,11 systematic review/Meta-analysis,and 8 economic evaluation researches were included.Pioglitazone combined with metformin could significantly decrease the level of glycated hemoglobin in patients with type 2 diabetes mellitus with no increasing risk of adverse drug reaction and hypoglycemia.Meanwhile,compared with combination use of pioglitazone and metformin,the compound preparation of the two drugs could improve the compliance of patients.Pioglitazone combined with metformin could prolong quality-adjusted life years(QALYs)and had a good cost-effectiveness.And the compound preparation of the two drugs did not increase the cost.Conclusion:Combination use of pioglitazone and metformin showed good safety,effi cacy and economics for type 2 diabetes mellitus.