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英克司兰治疗动脉粥样硬化性心血管疾病伴高胆固醇血症的快

          速卫生技术评估
                                   Δ


                                                     1
                                            1
                 1*
                                    1
          高 杏 ,刘天雅 ,张 倩 ,张 波 ,李 薇 ,刘 玲 (1. 徐州医科大学附属医院药学部,江苏 徐州
                                                             1 #
                           2
          221004;2.徐州医科大学附属医院麻醉科,江苏 徐州 221004)
          中图分类号  R973+.1;R969.3;R956      文献标志码  A      文章编号  1001-0408(2025)19-2460-06
          DOI  10.6039/j.issn.1001-0408.2025.19.18
          摘   要  目的  评估英克司兰在动脉粥样硬化性心血管疾病伴高胆固醇血症治疗中的有效性、安全性和经济性。方法  采用快速
          卫生技术评估(HTA)方法。通过检索PubMed、Embase、the Cochrane Library、中国知网、万方等中英文数据库和HTA官方网站,收
          集英克司兰相关HTA报告、系统评价(SR)/Meta分析和药物经济学研究,检索时限为建库起至2025年4月。通过文献筛选、数据
          提取及文献质量评价,对研究结果进行描述性分析和汇总。结果  最终纳入22篇文献,包括HTA报告1篇,SR/Meta分析15篇,药
          物经济学研究6篇。有效性方面,与对照组相比,英克司兰能够显著降低低密度脂蛋白胆固醇、前蛋白转化酶枯草溶菌素9、总胆
          固醇、甘油三酯、载脂蛋白B和脂蛋白(a)水平,升高高密度脂蛋白胆固醇水平,降低心血管不良事件风险。安全性方面,英克司兰
          组总不良事件、严重不良事件和非严重不良事件的发生风险与对照组差异无统计学意义,但是注射部位反应发生率升高,且多为
          轻度。经济性方面,国内外研究结论存在差异,更多研究表明英克司兰不具备经济性优势,需适当降价才能符合成本-效果标
          准。结论  英克司兰治疗动脉粥样硬化性心血管疾病伴高胆固醇血症疗效显著、安全性良好,但其经济性有待进一步提高。
          关键词  英克司兰;动脉粥样硬化性心血管疾病;高胆固醇血症;快速卫生技术评估

          Rapid  health  technology  assessment  of  inclisiran  in  the  treatment  of  atherosclerotic  cardiovascular  disease
          with hypercholesterolemia
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                    1
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          GAO Xing ,LIU Tianya ,ZHANG Qian ,ZHANG Bo ,LI Wei ,LIU Ling(1. Dept. of Pharmacy, the Affiliated
                                             1
          Hospital  of  Xuzhou  Medical  University,  Jiangsu  Xuzhou  221004,  China;2.  Dept.  of  Anesthesiology,  the
          Affiliated Hospital of Xuzhou Medical University, Jiangsu Xuzhou 221004, China)
          ABSTRACT    OBJECTIVE  To  evaluate  the  efficacy,  safety  and  economy  of  inclisiran  in  the  treatment  of  atherosclerotic
          cardiovascular  disease  with  hypercholesterolemia.  METHODS  A  rapid  health  technology  assessment (HTA)  approach  was
          employed.  HTA  reports,  systematic  reviews(SR)/meta-analyses,  and  pharmacoeconomic  studies  related  to  inclisiran  were
          systematically  identified  through  comprehensive  searches  of  Chinese  and  English  databases,  including  PubMed,  Embase,  the
          Cochrane  Library,  CNKI  and  Wanfang  database,  supplemented  by  HTA  institutional  repositories.  The  search  timeframe  spanned
          from  database  inception  to  April  2025.  The  results  of  the  studies  were  descriptively  analysed  and  summarized  through  literature
          screening, data extraction and literature quality assessment. RESULTS The final analysis included 22 studies, comprising one HTA
          report,  15  SR/meta-analyses,  and  6  pharmacoeconomic  evaluations.  Regarding  therapeutic  efficacy,  compared  with  control  group,
          inclisiran  could  significantly  reduce  the  levels  of  low-density  lipoprotein  cholesterol,  proprotein  convertase  subtilisin/kexin  type  9,
          total  cholesterol,  triacylglycerol,  apolipoprotein  B,  and  lipoprotein(a),  increase  the  level  of  high-density  lipoprotein  cholesterol,
          and  reduce  the  risk  of  adverse  cardiovascular  events.  In  terms  of  safety,  the  inclisiran  group  showed  no  significant  difference
          compared  with  the  control  group  in  the  risk  of  total  adverse  events,  serious  adverse  events,  or  non-serious  adverse  events;
          however, an increased incidence of injection site reactions was observed, most of which were mild. In terms of cost-effectiveness,
          there were discrepancies in research conclusions both domestically and internationally. More studies indicated that inclisiran did not
          demonstrate  cost-effectiveness  advantage  and  would  require  an  appropriate  price  reduction  to  meet  cost-effectiveness  criteria.
          CONCLUSIONS  Inclisiran  demonstrates  favorable  efficacy  and  acceptable  safety  in  treating  atherosclerotic  cardiovascular  disease
          with hypercholesterolemia, though its economic profile requires improvement.
          KEYWORDS     inclisiran; atherosclerotic cardiovascular disease; hypercholesterolemia; rapid health technology assessment

              Δ 基金项目 江苏省自然科学基金项目(No.BK20170258);江苏省
          药学会-石药医院药学科研基金项目(No.SY202306-3)                         心血管疾病是我国疾病负担最重的慢性病之一。
             *第一作者 副主任药师,硕士。研究方向:临床药学。电话:
                                                              国家心血管病中心2023年报告显示,我国心血管疾病患
          0516-85806336。E-mail:panda864170@126.com
                                                              病 人 数 为 3.3 亿 ,2020 年 死 亡 人 数 较 2015 年 增 长
              # 通信作者 副主任药师。研究方向:临床药学。电话:0516-
                                                                                     [1]
          85806336。E-mail:464800321@qq.com                    48.06%,医疗费用支出巨大 。心血管疾病的发病率逐

          · 2460 ·    China Pharmacy  2025 Vol. 36  No. 19                            中国药房  2025年第36卷第19期
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