阿扎胞苷治疗骨髓增生异常综合征的快速卫生技术评估

Rapid Health Technology Assessment of Azacitidine in the Treatment of Myelodysplastic Syndrome

目的:基于快速卫生技术评估方法,评价阿扎胞苷治疗骨髓增生异常综合征的有效性、安全性和经济性,高效、快捷地为临床药物选择和决策者提供循证依据。方法:系统检索中国知网、万方数据库、PubMed和the Cochrane Library等数据库,纳入阿扎胞苷与对照组(地西他滨或其他治疗手段)治疗骨髓增生异常综合征的系统评价/Meta分析、药物经济学研究等文献,由2名评价者根据纳入与排除标准独立筛选文献、提取资料和汇总数据后,最终采用定性描述的方法对结果进行定性分析。结果:共纳入7篇系统评价/Meta分析和2篇药物经济学研究文献。现有证据显示,阿扎胞苷治疗骨髓增生异常综合征在有效性方面较对照药物有一定的优势,且不增加患者的血液毒性。阿扎胞苷和地西他滨在我国均具有较好的经济性。结论:与支持治疗相比,去甲基化药物应优先被推荐用于治疗骨髓增生异常综合征患者;而与地西他滨比较,阿扎胞苷更具有有效性。

OBJECTIVE:To evaluate the efficacy,safety and economy of azacitidine in the treatment of myelodysplastic syndrome based on rapid health technology assessment,so as to provide evidence-based evidence for drug selection and decision-makers conveniently.METHODS:Systematic review/Meta-analysis and pharmacoeconomic studies on azacitidine and control group(decitabine or other treatments)in the treatment of myelodysplastic syndrome were systematically retrieved from CNKI,Wanfang Data,PubMed,the Cochrane Library and other databases.Literature screening,data extraction and summary were performed according to the inclusion and exclusion criteria by two evaluators independently,so that the conclusion was qualitatively analyzed through qualitative description.RESULTS:Totally seven systematic review/Meta-analysis and two pharmacoeconomic studies were included.Existing evidence indicated that compared with the control group,azacitidine had a certain advantage of efficacy in the treatment of myelodysplastic syndrome without increasing patients’hematotoxicity.Both azacitidine and decitabine had good economy in China.CONCLUSIONS:Compared with supportive treatment,the demethylation agents should be recommended for the treatment of myelodysplastic syndrome.Moreover,azacitidine is more effective than decitabine.