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          司美格鲁肽治疗2型糖尿病的快速卫生技术评估
                                                                                    Δ

                                              1, 2 #
                           1, 2
          王思骅    1, 2* ,汪 盛 ,王 岩 ,栾家杰 (1.皖南医学院药学院,安徽 芜湖 241002;2.皖南医学院弋矶山医
                                     1, 2
          院药学部,安徽 芜湖 241001)
          中图分类号  R977.1+5      文献标志码  A      文章编号  1001-0408(2023)12-1503-06
          DOI  10.6039/j.issn.1001-0408.2023.12.18


          摘  要  目的  评价司美格鲁肽治疗2型糖尿病(T2DM)的有效性、安全性和经济性,为临床用药提供参考。方法  采用快速卫生
          技术评估(HTA)方法。计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据、中国生物医学文献服
          务系统及国内外HTA机构官方网站,收集司美格鲁肽治疗T2DM的HTA报告、系统评价/Meta分析和药物经济学研究,检索时限
          均为建库起至2022年5月1日。资料提取和质量评价后,对纳入研究的结果进行描述性分析。结果  共纳入22篇文献,包括7篇
          Meta分析和15篇药物经济学研究。有效性和安全性方面,司美格鲁肽在控制糖化血红蛋白(HbA1c)、空腹血糖、餐后平均血糖、
          体质量指数、HbA1c水平<7%达标率方面疗效显著,未增加低血糖和严重不良反应的发生风险,但胃肠道不良反应发生率较高。
          经济性方面,国外研究结果显示,与其他胰高血糖素样肽1受体激动剂、钠-葡萄糖协同转运蛋白2抑制剂、二肽基肽酶4抑制剂等
          比较,司美格鲁肽均具有经济学优势;基于中国卫生体系角度下的研究表明,以2020年我国人均国内生产总值(72 477元)作为意
          愿支付阈值时,司美格鲁肽较度拉糖肽具有经济学优势。结论  司美格鲁肽治疗T2DM的有效性和安全性均较好,且与其他治疗
          药物比较具有经济学优势,但需注意胃肠道反应的发生风险。
          关键词  司美格鲁肽;2型糖尿病;有效性;安全性;经济性;快速卫生技术评估

          Semaglutide in the treatment of type 2 diabetes mellitus: rapid health technology assessment
                                                     1, 2
                                                                    1, 2
          WANG Sihua ,WANG Sheng ,WANG Yan ,LUAN Jiajie (1.  Dept.  of  Pharmacy,  Wannan  Medical
                      1, 2
                                      1, 2
          College,  Anhui  Wuhu  241002,  China;2.  Dept.  of  Pharmacy,  Yijishan  Hospital  of  Wannan  Medical  College,
          Anhui Wuhu 241001, China)
          ABSTRACT   OBJECTIVE  To  evaluate  the  efficacy,  safety  and  cost-effectiveness  of  semaglutide  in  the  treatment  of  type  2
          diabetes  mellitus (T2DM),  and  to  provide  reference  for  clinical  drug  use.  METHODS  Rapid  health  technology  assessment  was
          adopted.  Retrieved  from  PubMed,  Embase,  Cochrane  Library,  Web  of  Science,  CNKI,  Wanfang  database,  CBM,  domestic  and
          foreign  HTA  official  websites,  HTA  reports,  systematic  evaluation/meta-analysis  and  pharmacoeconomic  studies  about  semaglutide
          in  the  treatment  of  T2DM  were  collected  during  the  inception  to  May  1st,  2022.  After  data  extraction  and  quality  evaluation,
          descriptive  analysis  was  performed  on  the  results  of  included  studies.  RESULTS  A  total  of  22  pieces  of  literature  were  included,
          involving  7  meta-analyses  and  15  pharmacoeconomic  studies.  In  terms  of  efficacy  and  safety,  semaglutide  showed  significant
          advantages in  controlling glycated hemoglobin (HbA1c),  fasting  blood  glucose,  postprandial mean glucose,  body  mass  index  and
          achieving a target of glycosylated hemoglobin level <7%; also, there was no increased risk of hypoglycaemia or the incidence of
          serious adverse effects, but the risk of gastrointestinal adverse effects was  significantly higher than other interventions. In terms of
          cost-effectiveness,  results  of  foreign  studies  showed  that  semaglutide  was  more  cost-effective,  compared  with  other  glucagon-like
          peptide-1 receptor agonists, sodium-glucose transporter protein 2 inhibitors, dipeptidyl peptidase-4 inhibitors. Research based on the
          perspective of China’s health system showed that semaglutide had a clear cost-effectiveness advantage over dulaglutide when using
          GDP  per  capita  in  2020 (72  477  yuan)  as  the  payment  threshold.  CONCLUSIONS  The  semaglutide  has  excellent  efficacy  and
                                                             good safety for the treatment of T2DM, with cost-effectiveness
             Δ 基金项目 安徽省科技计划项目(No.1604a0802097);北京康盟
          慈善基金会医学科研发展基金-临床与基础研究专项(No.YXKY-                   advantages  over  a  number  of  drugs,  but  attention  should  be
          WS005E)                                            paid to the occurrence of gastrointestinal adverse effects.
             * 第一作者 硕 士 研 究 生 。 研 究 方 向 :临 床 药 学 。 E-mail:   KEYWORDS     semaglutide;  type  2  diabetes  mellitus;
          wongsh@stu.wnmc.edu.cn
                                                             efficacy;  safety;  cost-effectiveness;  rapid  health  technology
             # 通信作者 主任药师,教授,硕士生导师,博士。研究方向:个体
          化精准用药与药事管理。E-mail:luanjiajie757@163.com            assessment


          中国药房  2023年第34卷第12期                                              China Pharmacy  2023 Vol. 34  No. 12    · 1503 ·
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