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得,rhTPO的有效率更高、不良事件更少,可改善患者的 blind,double-dummy,randomised study of recombinant
生存质量并减少成本,在多数情况下为二线治疗 ITP 的 human thrombopoietin versus eltrombopag in the treat-
绝对优势方案。 ment of immune thrombocytopenia in Chinese adult pa-
本研究有以下局限性:首先,由于受临床试验数据 tients[J]. Br J Haematol,2021,195(5):781-789.
[11] 蔡华聪,王书杰,富玲,等.重组人血小板生成素用于原发
限制,本研究仅测算了rhTPO和艾曲泊帕治疗12周后的
免疫性血小板减少症维持治疗的有效性和安全性:多中
成本和健康产出,但ITP为慢性病,疾病进展周期长,使
心临床研究[J].中华血液学杂志,2017,38(5):379-383.
用不同药物后的健康产出和成本优势在短期内难以充 [12] PATEL V L,MAHÉVAS M,LEE S Y,et al. Outcomes 5
分体现,因此上述2种药物的长期经济性有待进一步考
years after response to rituximab therapy in children and
量。其次,敏感性分析结果显示rhTPO和艾曲泊帕用量 adults with immune thrombocytopenia[J]. Blood,2012,
对结果有较大影响,但在临床实际用药过程中,患者多 119(25):5989-5995.
根据PLT水平实施个性化给药方案,本研究中的用药方 [13] 刘新光,刘晓帆,孟月生,等.重组人血小板生成素联合小
案可能未反映所有的用药情况,在某些用药方案中两者 剂量利妥昔单抗治疗激素无效/复发成人 ITP 的多中心
的经济性比较结果可能存在差异。 临床研究[J].临床血液学杂志,2015,28(9):778-781.
综上所述,在现有证据下,rhTPO相较艾曲泊帕用于 [14] 李瑾,周泽平,刘琳.成人原发免疫性血小板减少症患者
二线治疗ITP在短期内更具有经济性。待有关数据完善 出血的危险因素[J].四川医学,2019,40(12):1276-1280.
后,未来还应开展进一步研究,以比较两者的长期经济性。 [15] WEITZ I,SANZ M A,HENRY D,et al. A novel approach
to the evaluation of bleeding-related episodes in patients
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·1114 · China Pharmacy 2022 Vol. 33 No. 9 中国药房 2022年第33卷第9期