基于Meta分析的富马酸伏诺拉生治疗幽门螺杆菌的药物经济学研究

Pharmacoeconomics of Vonoprazan in treatment of Helicobacter pylori based on Meta-analysis

目的系统评价富马酸伏诺拉生与质子泵抑制剂(PPI)用于幽门螺杆菌治疗的安全有效性与药物经济性,为临床用药提供参考。方法收集截至2021年11月在PubMed、Embase、Cochrane library、Web of Science、中国知网、万方数据库和维普中文期刊数据库等发表的富马酸伏诺拉生与PPI用于幽门螺杆菌根除的随机对照实验(RCT)。通过筛选和数据提取,在Revman 5.3软件中对符合纳入标准的研究进行系统性分析。并采用成本-效果分析法进行药物经济学研究。结果最终筛选出8项符合条件的研究,包含1220例受试对象。结果显示在治疗幽门螺杆菌时富马酸伏诺拉生的根除效果相较于PPI更优[合并根除率93.1%与78.2%,OR(95%CI):3.83(2.65,5.53),P<0.01],不良反应发生情况差异有统计学意义[OR(95%CI):0.75(0.57,0.99),P=0.04]。增量成本-效果分析显示,富马酸伏诺拉生与PPI用于治疗幽门螺杆菌增加的成本完全值得。结论富马酸伏诺拉生对根除幽门螺杆菌具有显著疗效和较好的安全性及经济性,值得进一步研究。

Objective To investigate the safety,efficacy and pharmacoeconomics of Vonoprazan and pro-ton pump inhibitors(PPIs)as a treatment of Helicobacter pylori based on systematic review,and to provide evi-dence for clinical medication.Methods Randomized controlled trials(RCTs)on Vonoprazan and PPI for Heli-cobacter pylori eradication published in databases such as PubMed,Embase,Cochrane library,Web of Science,CNKI,Wanfang Database and VIP Chinese journals as of November 2021 were retrieved.After screening and da-ta extraction,a systematic analysis of studies that met the inclusion criteria was performed with Revman 5.3 soft-ware.The cost-effectiveness analysis was used to study the pharmacoeconomics.Results Eight eligible studies were finally screened,including 1220 subjects.The results showed that the eradication of Helicobacter pylori by Vonoprazan was more significant than that by PPI[combined eradication rate:93.1%-78.2%,OR(95%CI):3.83(2.65-5.53),P<0.01],The incidence rate of adverse reactions was significantly different between the two agents[OR(95%CI):0.75(0.57,0.99),P=0.04].Incremental cost-effectiveness analysis showed that the increase in costs of Vonoprazan and PPI was well worthwhile for treatment of Helicobacter pylori.Conclusion Vonoprazan leads to significant therapeutic efficacy in eradicating Helicobacter pylori,with good safety and cost-effectiveness,and therefore warrants further study.