二甲双胍联合达格列净治疗2型糖尿病的 快速卫生技术评估

摘要/Abstract

摘要： 目的：基于快速卫生技术评估的方法，评价二甲双胍联合达格列净治疗2型糖尿病的安全性、有效性、经济性，为临床用药提供参考，为决策者提供循证依据。方法：系统检索PubMed、Cochrane图书馆、Embase、中国知网、万方、维普和CRD等国内外数据库，检索时限均为建库起至2021年12月止。根据纳排标准筛选文献并提取数据，对纳入文献进行质量评价和定性描述分析。结果：共纳入3篇系统评价/Meta分析，11篇经济性研究。在有效性和安全性方面，与二甲双胍联合安慰剂组相比，二甲双胍联合达格列净组有效降低二型糖尿病患者糖化血红蛋白、空腹血糖和体重水平，不增加低血糖发生风险，但泌尿系感染和生殖器感染的发生率增加；与二甲双胍、达格列净、沙格列汀三联用药相比，二甲双胍联合达格列净组降低糖化血红蛋白、体重、收缩压和舒张压水平的效果较差，生殖器感染率较高。在经济性方面，二甲双胍联合达格列净组治疗成本较低，可延长患者的质量调整生命年，具有较高的经济优势。结论：二甲双胍联合达格列净作为2型糖尿病的治疗方案具有良好的有效性、安全性和经济性。

关键词: font-size:medium, ">达格列净；二甲双胍；2型糖尿病；快速卫生技术评估

Abstract: Objective：The rapid health technology assessment was used to evaluate the combined use of dapagliflozin plus metformin in the treatment of type 2 diabetes mellitus from the three dimensions of safety， efficacy and economics. Methods：PubMed， Cochrane Library， Embase， CNKI， Wanfang， VIP and CRD were searched， and the search time limit from the establishment of the database to December 2021. Screened the literature and extracted the data based on inclusion and exclusion criteria， evaluated the quality of the included literature and qualitative description analyzed. Results： A total of 3 systematic reviews/Meta- analyses， and 11 economic evaluation researches were included. In terms of efficacy and safety， compared with metformin combined with placebo， metformin combined with dapagliflozin could significantly decrease the level of glycated hemoglobin， fasting blood glucose and body weight in patients with type 2 diabetes mellitus with no increasedrisk of hypoglycemia， but the incidence of urinary and genital infections increased. While comparing with metformin， dapagliflozin and saxagliptin triple combinations， metformin combined with dapagliflozin were less effective in reducing glycosylated hemoglobin， body weight， systolic blood pressure and diastolic blood pressure， and with higher genital infection rate. In terms of economics， metformin combined with dapagliflozin has a lower cost， can prolong the quality-adjusted life years of patients， and has a significant economic advantage. Conclusion： Combination use of metformin and dapagliflozin show good safety， efficacy and economics for type 2 diabetes mellitus.

Key words: Dapagliflozin, Metformin, Type 2 diabetes mellitus, Rapid health technology assessment

中图分类号:

何芳芳, 宋沧桑, 张阳, 张函舒, 王国徽, 李兴德, . 二甲双胍联合达格列净治疗2型糖尿病的快速卫生技术评估[J]. 中国药物评价, 2022, 39(3): 248-253.

HE Fang-fang, SONG Cang-sang, ZHANG Yang, ZHANG Han-shu, WANG Guo-hui, LI Xing-de, . Rapid Health Technology Assessment of Metformin Plus Dapagliflozin in Treatment of Type 2 Diabetes Mellitus[J]. CHINESE JOURNAL OF DRUG EVALUATION, 2022, 39(3): 248-253.

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