托珠单抗治疗幼年型特发性关节炎的快速卫生技术评估

Tocilizumab for juvenile idiopathic arthritis:a rapid health technology assessment

目的评价托珠单抗治疗幼年特发性关节炎的有效性、安全性和经济性,为临床用药以及国家基本药物目录的准入提供循证依据。方法通过计算机在6个PubMed、Embase、Cochrane Library与中国知网、万方、SinoMed中英文数据库以及8个HTA相关网站进行检索。内容包括与托珠单抗和幼年特发性关节炎相关的文献。由2位评价者根据纳入与排除标准独立筛选文献、提取资料,并进行定性分析和快速卫生技术评估。结果共纳入22项系统评价/Meta分析和4项经济学研究,综合比较和描述性分析了托珠单抗治疗幼年特发性关节炎的有效性、安全性和经济性。与安慰剂组的风险比(RR)为1.48[95%CI:1.03~2.13]。22篇文献均显示严重的不良事件发生率罕见。经济性研究结果显示,使用托珠单抗可以获得更好的成本效果。结论托珠单抗治疗幼年特发性关节炎具有较好的有效性、安全性、经济性。

Objective To evaluate the efficacy,safety and economy of tocilizumab for juvenile idiopathic arthritis(JIA)and provide evidence for clinical treatment and potential entry to the National Essential Medicine List.Methods Six Chinese and English databases including PubMed,Embase,Cochrane Library,CNKI,Wanfang and SinoMed were searched by computer,as well as eight HTA related websites.Content includes literature related to tocilizumab and JIA.Two reviewers independently screened the literatures,collected the data,and conducted qualitative analysis and rapidly assessed the health technology.Results Totally 22 systematic review/Meta-analysis and 4 economic studies were included.The efficacy,safety and economy of tocilizumab for JIA were analyzed.The risk ratio was 1.48[95%confidence interval:1.03~2.13].All 22 reports in the literature showed rare adverse events.The economics study showed better cost-effect can be achieved with tocilizumab.Conclusion Tocilizumab is effective,safe and economic for JIA.