布南色林治疗精神分裂症的快速卫生技术评估

Rapid health technology assessment of blonanserin in the treatment of schizophrenia

目的评价布南色林治疗精神分裂症的有效性、安全性和经济性,为精神科临床用药提供参考。方法系统检索PubMed、Cochrane图书馆、知网、万方、CBM、维普等数据库和卫生技术评估相关网站,检索起止时间为建库至2020年12月12日,根据纳入和排除标准筛选文献、评价质量、提取数据,对提取的数据进行定性分析。结果共纳入4篇系统评价/Meta分析、1篇经济学研究。布南色林对精神分裂症阴性症状的疗效优于氟哌啶醇(P=0.01),对精神分裂症阳性和阴性症状量表(PANSS)评分改善优于阿立哌唑(P=0.003),对精神分裂症的疗效呈剂量依赖性增加。布南色林引起高催乳血症、体重增加的风险较低,有锥体外系、静坐不能等不良反应,但安全性相对较高。经预测,布南色林纳入医疗保险目录后,可节约不良反应处理费用,对医保基金影响总体安全可控。结论布南色林在治疗精神分裂症方面具有良好的有效性、安全性、经济性。

Objective To evaluate the efficacy,safety and economy of blonanserin in the treatment of schizophrenia and provide reference for clinical medication in psychiatry.Methods PubMed,Cochrane Library,CNKI,Wanfang,CBM and VIP and health technology assessment(HTA)related websites were systematically retrieved from the establishment of the database to December 12,2020,the data were evaluated and extracted according to the inclusion and exclusion criterion and the qualitative analysis were conducted.Results Four systematic reviews/metaanalyses and one economic study were included.Blonanserin had better efficacy on negative symptoms of schizophrenia than haloperido(P=0.01)and was superior to aripiprazole in improving the score of positive and negative syndrome scale(PANSS)of schizophrenia(P=0.003).The efficacy of blonanserin for schizophrenia increased in a dosedependent manner.Although there were some adverse reactions such as extrapyramidal system and akathisia,the safety of blonanserin was relatively high with lower risk of hyperprolactinemia and weight gain.It was predicted that after being included into the medical insurance catalogue,blonanserin could save the cost of treatment for adverse reactions,and the influence on the medical insurance fund was generally safe and controllable.Conclusion Blonanserin has good efficacy,safety and economy in the treatment of schizophrenia.