| 引用本文: | 刘俏,许清青,易利丹,罗霞.缬沙坦治疗慢性肾脏病合并高血压的Meta分析及药物经济学评价[J].中国现代应用药学,2025,42(1):82-88. |
| liu qiao,xu qingqing,198302,luo xia.Meta-analysis and pharmacoeconomics evaluation of valsartan in the treatment of chronic kidney disease with hypertension[J].Chin J Mod Appl Pharm(中国现代应用药学),2025,42(1):82-88. |
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| 摘要: |
| 目的? 基于Meta分析研究缬沙坦治疗慢性肾脏病合并高血压的有效性与安全性,以及开展药物经济学研究,为合理用药提供指导,同时为相关医疗卫生决策提供证据。方法? 计算机检索PubMed、Embase、The Cochrane Library、中国知网、万方、维普等数据库,搜集有关缬沙坦治疗慢性肾脏病合并高血压的文献资料,对其治疗慢性肾脏病合并高血压的有效性和安全性进行Meta分析,并采用增量成本效果比(ICER)进行经济学评价,同时进行敏感性分析。结果? 共纳入有效文献8篇,包括1586例患者。Meta分析结果显示,相较于硝苯地平控释片单药,缬沙坦联合硝苯地平控释片能改善指标SBP(MD(95%CI):14.86 [11.21,18.50])、DBP(MD(95%CI):14.12 [6.46,21.79])和UAER(MD(95%CI):14.84 [7.48, 22.20]),但增加不良反应(RR(95%CI):0.29 [0.12, 0.67]),且差异均有统计学意义(P<0.01)。从卫生体系角度出发,以血压值、UAER值和降压有效率为效果指标,药物经济学分析结果显示缬沙坦单药或联合硝苯地平控释片与其他方案比较,ICER均小于1倍人均可支配收入或效果更佳的同时成本更低。敏感性分析结果与基础分析结果基本一致。结论 缬沙坦单药或联合硝苯地平控释片相较于其他药物方案在慢性肾脏病合并高血压治疗中有效性和经济性具有一定优势,但使用缬沙坦联合治疗导致不良反应的概率会增加,安全性更低。但受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。 |
| 关键词: 缬沙坦 慢性肾脏病 高血压 效果 经济性 |
| DOI： |
| 分类号:R284.1；R917.101?????? |
| 基金项目:湖 南 省 卫 健 委 科 研 项 目(No. 202113050611；No. 202213053462)和 湖 南 省 自 然 科 学 基 金 课 题(No. 2021JJ40817；No. 2022JJ80040) |
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| Meta-analysis and pharmacoeconomics evaluation of valsartan in the treatment of chronic kidney disease with hypertension |
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liu qiao1, xu qingqing2, 1983021, luo xia1
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1.Department of Pharmacy, the Second Xiangya Hospital of Central South University;2.Central South University School of Public Administration, Changsha 410002, China
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| Abstract: |
| OBJECTIVE To study the efficacy and safety of valsartan in the treatment of chronic kidney disease complicated with hypertension based on meta-analysis, and to conduct pharmacoeconomic research, so as to provide guidance for rational drug use and provide evidence for related medical and health decisions. METHODS PubMed, Embase, The Cochrane Library, CNKI, Wanfang, Weipu and other databases were searched to collect literature on valsartan in the treatment of chronic kidney disease complicated with hypertension, meta-analysis was conducted for its efficacy and safety in the treatment of chronic kidney disease complicated with hypertension, and the incremental cost-effectiveness ratio (ICER) was used for economic evaluation，and probabilistic sensitivity analysis were performed. RESULTS A total of 8 valid literatures, including 1586 patients. Meta-analysis showed that valsartan in combination with nifedipine controlled release tablets improved the measures SBP (MD (95% CI): 14.86 [11.21, 18.50]), DBP (MD (95% CI): 14.12 [6.46, 21.79]) and UAER (MD (95% CI): 14.84 [7.48, 22.20]), but increased adverse effects (RR (95% CI): 0.29 [0.12, 0.67]), and the differences were statistically significant (P<0.01), when compared to nifedipine controlled release tablets alone. From the health system perspective，and using the blood pressure value, UAER value, and blood pressure reduction efficiency as the effectiveness indicators, the results of the pharmacoeconomics evaluation showed that valsartan alone or in combination with nifedipine controlled release tablets had an ICER of less than one times per capita disposable income or had better effectiveness with lower costs when compared to other regimens. The results of the sensitivity analysis were basically consistent with the results of the basic analysis. CONCLUSION Compared with other drug regimens, valsartan alone or in combination with nifedipine controlled release tablets has certain advantages in efficacy and economy in the treatment of chronic kidney disease and hypertension, but the probability of adverse reactions caused by the combination treatment of valsartan is increased and the safety is lower. However, due to limitations in the number and quality of included studies, these conclusions need to be validated by more high-quality studies. |
| Key words: valsartan chronic kidney disease hypertension effectiveness economy |
