司美格鲁肽周制剂对比其他GLP-1受体激动剂治疗2型糖尿病的快速卫生技术评估

Health technology assessment between weekly semaglutide and other GLP-1 receptor agonists on type 2 diabetes

目的 采用快速卫生技术评估的方法综合评估司美格鲁肽周制剂与国内7个已上市的胰高血糖素样肽-1受体激动剂(GLP-1RA)治疗2型糖尿病的有效性、安全性与经济性差异。方法 通过计算机检索PubMed、Web of Science、Embase、the Cochrane Library、中国学术期刊全文数据库(CNKI)、万方数据知识服务平台、维普生物医学数据库(VIP)、中国生物医学文献数据库(SinoMed)等数据库,同时检索国际卫生技术评估机构协作网、加拿大药物卫生技术局等卫生技术评估机构官方网站。根据纳入与排除标准筛选文献后,进行文献质量评价并提取数据,对有效性、安全性和经济性进行分析和对比。结果 文献筛选共纳入20篇系统评价/Meta分析、6篇经济学研究。有效性方面,司美格鲁肽周制剂在控制糖化血红蛋白(HbA1c)、HbA1c<7%合格率、空腹血糖(FBG)和降低体质量方面的疗效相比其他GLP-1RA具有明显优势。安全性方面,使用司美格鲁肽周制剂引发部分胃肠道不良反应的风险高于其他GLP-1RA,发生心血管不良反应和低血糖的风险与其他GLP-1RA无显著性差异。经济性方面,在中国医疗保障体系内,使用司美格鲁肽周制剂相比于其他GLP-1RA是更具有经济性的治疗方案。结论 司美格鲁肽周制剂在有效性和经济性方面比其他GLP-1RA更具有优势,其安全性与其他GLP-1RA差异不大,但需要注意胃肠道不良反应的发生。

Objective Fast health and technology assessment has been adopted to evaluate effectiveness,safety and economy between semaglutide and the other 7 GLP-1RAs previously registered in China toward type 2 diabetes.Methods PUBMED,Web of Science,Embase,The Cochrane Library,CNKI,Wanfang,Vip and other databases were searched simultaneously and systematically to retrieve corresponding literature.The official website of the International Health Technology Evaluation Institutions,the Canadian Pharmaceutical Health Technology Bureau and other health technology assessment agencies were also been browsed,the literature was screened and filtered by eligible criteria.Results A total of 20 system evaluation/meta analysis and 6 economic research finally remained.In terms of effectiveness,the efficacy of semaglutide in controlling glycated hemoglobin(HBA1C),HBA1C<7%qualification rate,fasting blood glucose(FPG),and lowering weight have obvious advantages compared to other GLP-1RAs.For safety aspect,the risk of semaglutide causing some gastrointestinal adverse reactions is higher than other GLP-1RAs,while the risk of adverse cardiovascular reactions and low blood sugar incidence was no difference to other GLP-1RAs.The economic assessment revealed that the use of semaglutide over other GLP-1RAs was a more economical therapy in the Chinese medical security system.Conclusion Semaglutide has an advantage in terms of effectiveness and economy than other GLP-1RAs.Its safety is not much different from other GLP-1RAs,while it is necessary to pay attention to the occurrence of adverse gastrointestinal reactions.