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替奈普酶治疗急性缺血性脑卒中的快速卫生技术评估

Tenecteplase in the treatment of acute ischemic stroke:a rapid health technology assessment
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摘要 目的评价替奈普酶治疗缺血性脑卒中的有效性、安全性和经济性,为临床合理用药和相关决策提供依据。方法系统检索PubMed、Cochrane图书馆、中国知网、万方数据以及卫生技术评估机构等官方网站,收集替奈普酶治疗急性缺血性脑卒中的系统评价/Meta分析、药物经济学研究和卫生技术评估报告,检索时限均为建库起至2024年6月30日。提取资料和评价质量后,对纳入研究的结果进行描述性分析。结果共纳入31篇文献,包括28篇系统评价/Meta分析和3篇药物经济学研究。有效性方面,与阿替普酶相比,替奈普酶(0.25 mg/kg)可显著提高患者的早期神经功能改善率,且在90 d优良神经功能预后率、90 d良好神经功能预后率及血管再通率方面均不劣于阿替普酶。安全性方面,与阿替普酶相比,替奈普酶不会增加出血发生率、症状性颅内出血发生率、3个月全因死亡率及颅内出血发生率。经济性方面,国外研究结果显示,替奈普酶较阿替普酶具有经济学优势。结论与阿替普酶相比,替奈普酶治疗急性缺血性脑卒中的有效性和安全性均较好,且具有经济学优势。 OBJECTIVE To assess the efficacy,safety and cost-effectiveness of tenecteplase in the treatment of acute ischemic stroke,and to provide a basis for clinical rational drug use and related decision-making.METHODS The related literature in the PubMed,the Cochrane Library,CNKI,Wanfang data and health technology assessment(HTA)databases were searched from the establishment of the database to June 30th,2024.Systematic reviews/meta-analyses,pharmacoeconomic studies and HTA reports on tenecteplase in the treatment of acute ischemic stroke were collected.After data extraction and quality assessment,descriptive analysis of the included studies was carried out.RESULTS A total of 31 articles were included,involving 28 systematic reviews/meta-analysis and 3 pharmacoeconomic studies.In terms of effectiveness,compared with alteplase,tenecteplase(0.25 mg/kg)could significantly increase the early neurological improvement;the 90 d excellent neurological recovery rate,90 d good neurological recovery rate,and recanalization were not inferior to alteplase.For safety,compared with alteplase,tenecteplase did not increase the incidence of hemorrhage,symptomatic intracranial hemorrhage,3-month mortality,or intracranial hemorrhage.In terms of cost-effectiveness,foreign research results showed that tenecteplase had economic advantages over alteplase.CONCLUSIONS Compared with alteplase,tenecteplase is effective and safe in the treatment of acute ischemic stroke,and it is cost-effective.
作者 邓晓媚 李会婷 门鹏 张哲弢 张瑾 史天陆 DENG Xiaomei;LI Huiting;MEN Peng;ZHANG Zhetao;ZHANG Jin;SHI Tianlu(Dept.of Pharmacy,the First Affiliated Hospital of USTC(Anhui Provincial Hospital),Hefei 230036,China;Anhui Provincial Key Laboratory of Precision Pharmaceutical Preparations and Clinical Pharmacy,Hefei 230001,China;Dept.of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Institute for Drug Evaluation,Peking University Health Science Center,Beijing 100191,China)
出处 《中国药房》 CAS 北大核心 2024年第20期2541-2547,共7页 China Pharmacy
基金 安徽省卫生健康科研项目(No.AHWJ2023A10141)。
关键词 替奈普酶 急性缺血性脑卒中 快速卫生技术评估 有效性 安全性 经济性 tenecteplase acute ischemic stroke rapid health technology assessment effectiveness safety cost-effectiveness
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