目的系统评价妇宁膨胀栓治疗高危型人乳头瘤病毒(HR-HPV)持续感染的临床疗效、安全性与经济性,为HR-HPV持续感染患者提供循证药学依据。方法计算机检索中英文数据库自建库至2024年6月,妇宁膨胀栓治疗HR-HPV持续感染的临床研究文献,由两...目的系统评价妇宁膨胀栓治疗高危型人乳头瘤病毒(HR-HPV)持续感染的临床疗效、安全性与经济性,为HR-HPV持续感染患者提供循证药学依据。方法计算机检索中英文数据库自建库至2024年6月,妇宁膨胀栓治疗HR-HPV持续感染的临床研究文献,由两位研究者根据纳入排除标准独立对文献进行筛选,然后进行数据提取。使用Cochrane手册评价纳入研究质量,运用R4.1.3软件进行Meta分析。药物经济学评价采用决策分析软件TreeAge Pro 2011进行成本-效果分析。结果共纳入8篇文献,共1281例患者,所有文献均为中文文献。Meta分析结果显示:妇宁膨胀栓治疗HR-HPV感染转阴率显著高于重组人干扰素α-2b制剂;妇宁膨胀栓治疗HR-HPV感染HPV-DNA病毒载量显著低于重组人干扰素α-2b制剂;妇宁膨胀栓治疗HR-HPV感染腰腹坠痛消失占比、阴道分泌物异常消失占比、外阴瘙痒消失占比均高于重组人干扰素α-2b制剂;妇宁膨胀栓治疗HR-HPV感染复发率显著低于重组人干扰素α-2b制剂;妇宁膨胀栓治疗HR-HPV感染不良反应发生率显著低于重组人干扰素α-2b制剂。经济学分析结果:①成本-效果分析:两组成本-效果比分别为:重组人干扰素α-2b阴道泡腾片组CER=6829.06,妇宁膨胀栓组CER=7444.94,ICER(ΔC/ΔE)=11993.40。妇宁膨胀栓降价至74.1元/枚,重组人干扰素α-2b阴道泡腾片组的成本-效果比(C/E)=6829.06。妇宁膨胀栓组的成本-效果比=6796.40;两组增量成本-效果比(ΔC/ΔE)=6555.18。②敏感性分析结果:药品价格分别向上、向下调整10%,妇宁膨胀栓组的成本-效果比最高为7237.29,最低为6355.51;重组人干扰素α-2b阴道泡腾片组的成本-效果比最高为7240.89,最低为6417.24。结论妇宁膨胀栓治疗HR-HPV持续感染疗效显著,可提高HPV转阴率,降低HPV-DNA病毒载量、复发率及不良反应发生率,降价至74.1元/枚后相较于重组人干扰素α-2b阴道泡腾片经济性更优。展开更多
It is a promising treatment strategy to use a nanoparticle-based drug delivery system for cancer patients, which can simultaneously deliver multiple drugs or genes in combination with therapy to induce synergistic eff...It is a promising treatment strategy to use a nanoparticle-based drug delivery system for cancer patients, which can simultaneously deliver multiple drugs or genes in combination with therapy to induce synergistic effects and suppress drug resistance to the tumor. In this study, cationic nanostructured lipid carriers（cNLC） for co-loading anionic small-interfering RNAs（siRNA） and chemotherapeutic docetaxel（DTX） were prepared from different cationic lipids based on particle distribution and loading efficiency. In order to increase the cNLC＇s positive targeting capacity, a novel peptide SP94 was bound to the surface of cNLC（SP94-cNLC）. The cNLC showed good efficiency in loading siRNA and DTX. The SP94-cNLC revealed a better cytotoxicity compared with cNLC and Taxotere？, indicating that SP94 could successfully enhance the internalization capacity of nanoparticles to the liver cancer cells. This new type of cNLC is a potential vehicle when using in co-delivery of chemotherapeutics and siRNAs. The curcumin（CUR）/DTX co-delivery NLC could load both CUR and DTX in high efficiency and showed a sensibilization to DTX chemotherapy. The sensibilization was more obvious when it was used in the aggressive and resistant cancer cells. This CUR/DTX co-delivery system had good potential in treating cancer cells when chemotherapy drug showed little effect alone.展开更多
文摘目的系统评价妇宁膨胀栓治疗高危型人乳头瘤病毒(HR-HPV)持续感染的临床疗效、安全性与经济性,为HR-HPV持续感染患者提供循证药学依据。方法计算机检索中英文数据库自建库至2024年6月,妇宁膨胀栓治疗HR-HPV持续感染的临床研究文献,由两位研究者根据纳入排除标准独立对文献进行筛选,然后进行数据提取。使用Cochrane手册评价纳入研究质量,运用R4.1.3软件进行Meta分析。药物经济学评价采用决策分析软件TreeAge Pro 2011进行成本-效果分析。结果共纳入8篇文献,共1281例患者,所有文献均为中文文献。Meta分析结果显示:妇宁膨胀栓治疗HR-HPV感染转阴率显著高于重组人干扰素α-2b制剂;妇宁膨胀栓治疗HR-HPV感染HPV-DNA病毒载量显著低于重组人干扰素α-2b制剂;妇宁膨胀栓治疗HR-HPV感染腰腹坠痛消失占比、阴道分泌物异常消失占比、外阴瘙痒消失占比均高于重组人干扰素α-2b制剂;妇宁膨胀栓治疗HR-HPV感染复发率显著低于重组人干扰素α-2b制剂;妇宁膨胀栓治疗HR-HPV感染不良反应发生率显著低于重组人干扰素α-2b制剂。经济学分析结果:①成本-效果分析:两组成本-效果比分别为:重组人干扰素α-2b阴道泡腾片组CER=6829.06,妇宁膨胀栓组CER=7444.94,ICER(ΔC/ΔE)=11993.40。妇宁膨胀栓降价至74.1元/枚,重组人干扰素α-2b阴道泡腾片组的成本-效果比(C/E)=6829.06。妇宁膨胀栓组的成本-效果比=6796.40;两组增量成本-效果比(ΔC/ΔE)=6555.18。②敏感性分析结果:药品价格分别向上、向下调整10%,妇宁膨胀栓组的成本-效果比最高为7237.29,最低为6355.51;重组人干扰素α-2b阴道泡腾片组的成本-效果比最高为7240.89,最低为6417.24。结论妇宁膨胀栓治疗HR-HPV持续感染疗效显著,可提高HPV转阴率,降低HPV-DNA病毒载量、复发率及不良反应发生率,降价至74.1元/枚后相较于重组人干扰素α-2b阴道泡腾片经济性更优。
基金National Natural Science Foundation of China(Gr ant No.81273454)Beijing Natural Science Foundation(Grant No.7132113)Doctoral Foundation of the Ministry of Education(Grant No.20100001110056 and 20130001110055)
文摘It is a promising treatment strategy to use a nanoparticle-based drug delivery system for cancer patients, which can simultaneously deliver multiple drugs or genes in combination with therapy to induce synergistic effects and suppress drug resistance to the tumor. In this study, cationic nanostructured lipid carriers（cNLC） for co-loading anionic small-interfering RNAs（siRNA） and chemotherapeutic docetaxel（DTX） were prepared from different cationic lipids based on particle distribution and loading efficiency. In order to increase the cNLC＇s positive targeting capacity, a novel peptide SP94 was bound to the surface of cNLC（SP94-cNLC）. The cNLC showed good efficiency in loading siRNA and DTX. The SP94-cNLC revealed a better cytotoxicity compared with cNLC and Taxotere？, indicating that SP94 could successfully enhance the internalization capacity of nanoparticles to the liver cancer cells. This new type of cNLC is a potential vehicle when using in co-delivery of chemotherapeutics and siRNAs. The curcumin（CUR）/DTX co-delivery NLC could load both CUR and DTX in high efficiency and showed a sensibilization to DTX chemotherapy. The sensibilization was more obvious when it was used in the aggressive and resistant cancer cells. This CUR/DTX co-delivery system had good potential in treating cancer cells when chemotherapy drug showed little effect alone.
