摘要
目的:采用循证方法对奥氮平与阿瑞匹坦联合5-HT_3拮抗剂和地塞米松预防化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting, CINV)进行药物经济学评价。方法:计算机检索Pubmed、 Central、 Embase、CNKI、和Wanfang数据库,查找有关奥氮平与阿瑞匹坦比较其在CINV预防方面的随机对照试验(RCT),检索时限均为建库时间至2018年3月。同时手检相关期刊与会议论文。采用RevMan 5.3软件进行meta分析。结果:共纳入4个RCT,包括患者447例。有效性方面:两种预防方案的全程CINV缓解率相当(P>0.05),奥氮平组急性期呕吐缓解率(OR=1.87, 95%CI:1.08～3.27,P<0.05)、延迟期恶心控制率(OR=2.78, 95%CI:1.85～4.19),P<0.05)优于阿瑞匹坦组;安全性方面:阿瑞匹坦组患者呃逆症状发生率更高(RD=-0.20, 95%CI:-0.37～-0.03),P<0.05);经济性方面:奥氮平组成本明显低于阿瑞匹坦组,具有较大经济学优势。结论:奥氮平联合5-HT3拮抗剂和地塞米松三联止吐方案安全、有效、经济,适合临床推广。
Objective： To evaluate the pharmacoeconomics of olanzapine and aprepitant combining with 5-HT3 antagonist and dexamethasone in the prevention of chemotherapy-induced nausea and vomiting （CINV） using evidence-based method. Methods： Pubmed, Central, Emhase, CNKI, and Wanfang databases were searched for randomized controlled trials （RCTs） of olanzapine versus aspirin in the prevention of CINV. The retrieval time was from the database begining to March 2018. At the same time, related periodicals and conference papers were hand checked, RevMan 5. 3 software was used for meta-analysis. Results： 4 RCTs involving 447 patients were included. In the term of effectiveness, the remission rate of CINV was similar between the two prophylaxis reghneus （P〉0.05） . The remission rate of acute vomiting （OR =1.87, 95%CI： 1.08 -3.27, P〈0.05） and the control rate of delayed nausea （OR =2. 78, 95%CI： 1.85 -4, 19, P 〈0. 05） in the olanzapine group were superior to that in the aspirin group. In the term of safeness, the incidence of hiccup symptoms was higher in patients （RD = -0. 20, 95%CI： -0. 37 - -0. 03, P 〈0. 05） . In the term of pharcs, the cost of olanzapine group was significantly lower than that of aspirin group. Conclusion： Olanzapine combining with 5-HTs antagonist and dexamethasone is a secure and efficient scheme for the prevention of CINV, and it is suitable for clinical promotion.
作者
石亚飞
陈伟
王会凌
李春雨
戚妹娅
李国辉
SHI Ya-fei, CHEN Wei, WANG Hui-ling, LI Chun-yu, QI Shu-ya, LI Guo-hui(Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021 , China)
出处
《临床药物治疗杂志》
2018年第9期14-18,28,共6页
Clinical Medication Journal
基金
中国医学科学院医学与健康科技创新工程重大协同创新项目(2016-12M-1-001)
关键词
奥氮平
阿瑞匹坦
化疗所致恶心呕吐
药物经济学
olanzapine
aprepitant
chemotherapy-induced nausea and vomiting
pbarmacoeconomics
