德谷胰岛素利拉鲁肽注射液治疗成年2型糖尿病患者有效性、安全性和经济性的快速卫生技术评估

Effectiveness,safety and economy of insulin degludec and liraglutide injection in the treatment of adult type 2 diabetes mellitus patients: a rapid health technology assessment

目的采用快速卫生技术评估(RHTA)方法评价德谷胰岛素利拉鲁肽注射液治疗成年2型糖尿病(T2DM)患者的有效性、安全性和经济性,为临床用药决策提供循证依据。方法通过系统检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、维普网及中国生物医学文献数据库,同时在线检索国内外卫生技术评估机构官方网站及相关数据库,检索时限均从建库至2021年6月,由2位研究者根据文献纳入与排除标准进行文献筛选、质量评价及数据提取,并对数据结果进行分析。结果最终纳入2篇卫生技术评估(HTA)报告、1篇系统评价/Meta分析和13篇经济学研究,纳入文献总体质量较高。HTA报告结果显示,采用德谷胰岛素利拉鲁肽注射液治疗成年T2DM患者在糖化血红蛋白(HbA_(1c))、HbA_(1c)达标率、空腹血糖(FBG)水平与对照方案均无差异或优于对照方案,但相对于其他胰岛素治疗,其在患者体质量变化上具有优势;相较于其他对照方案,采用德谷胰岛素利拉鲁肽注射液治疗成年T2DM患者的不良反应总发生率差异无统计学意义,且其不增加低血糖发生风险。纳入的经济学研究结果显示,德谷胰岛素利拉鲁肽注射液具有较好的经济性。结论基于当前循证证据,德谷胰岛素利拉鲁肽注射液治疗成年T2DM患者具有较高的有效性、安全性及经济性。

Objective To evaluate the effectiveness,safety and economy of insulin degludec and liraglutide injection in the treatment of adult type 2 diabetes mellitus(T2DM)patients by rapid health technology assessment(RHTA),so as to provide references for clinical decision-making.Methods PubMed,Embase,Cochrane Library,Web of Science and CNKI、Wangfang Data,VIP,CBM databases and professional HTA websites and databases were systematically searched.The search deadline is from the establishment of the database to June 2021.Two reviewers independently identified studies,extracted data and assessed the quality of included studies.Qualitative analysis was performed.Results A total of 2 HTA reports,one Meta-analysis and 13 pharmacoeconomic studies were included.The overall quality of the included studies were high.2 HTA reports showed that,insulin degludec and liraglutide injection had no difference or was better than the control scheme in HbA_(1c) level,control rate of HbA_(1c),FBG level in the treatment of adult T2DM patients,but it had advantage in the change of patients′body mass compared with other insulin.Compared with other control schemes,there was no difference in the total incidence of adverse reactions in adult T2DM patients treated with insulin degludec and liraglutide injection,but it did not increase the risk of hypoglycemia.The included economic research results showed that insulin degludec and liraglutide injection had good economy.Conclusion Based on the current evidence-based evidence,insulin degludec and liraglutide injection has higher effectiveness,safety and economy in the treatment of adult T2DM patients.