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替尔泊肽用于2型糖尿病和长期体重管理的快速卫生技术评估
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| 篇名： | 替尔泊肽用于2型糖尿病和长期体重管理的快速卫生技术评估 |
| TITLE： | Rapid health technology assessment of tirzepatide for diabetes mellitus type 2 and long-term weight management |
| 摘要： | 目的 评价替尔泊肽用于2型糖尿病和长期体重管理的有效性、安全性和经济性，为临床药物治疗及医保政策制定提供循证依据。方法检索Embase、PubMed、theCochraneLibrary、中国知网和国际卫生技术评估（HTA）官方网站，收集替尔泊肽用于T2DM和长期体重管理的HTA报告、系统评价/Meta分析和药物经济学研究，检索时限均为建库至2024年10月1日。经资料提取、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18篇文献，包括14篇系统评价/Meta分析和4篇药物经济学研究，未检索到HTA报告。在有效性方面，绝大多数研究表明，替尔泊肽10、15mg在降低HbA1c、体重和腰围方面均显著优于其他胰高血糖素样肽1（GLP-1）受体激动剂（P＜0.05）。在安全性方面，与其他GLP-1受体激动剂比较，替尔泊肽未增加胃肠道相关不良事件（AE）发生率、≥3级AE发生率和严重低血糖发生率（P＞0.05），但替尔泊肽15mg可能会显著升高低血糖发生率和因不良反应退出率（P＜0.05）。在经济性方面，基于国外药物经济学研究的结果显示，替尔泊肽相比于司美格鲁肽和利拉鲁肽具有成本-效益优势。结论替尔泊肽10、15mg用于T2DM和长期体重管理的疗效和安全性均较好，但使用替尔泊肽15mg时，需密切关注其可能导致的低血糖风险和因不良反应退出风险；基于国外药物经济学研究结果，替尔泊肽具有经济学优势。 |
| ABSTRACT： | OBJECTIVE To evaluate the efficacy， safety and cost-effectiveness of tirzepatide for diabetes mellitus type 2 （T2DM） and long-term weight management， and provide evidence-based basis for clinical drug treatment and health insurance policy formulation. METHODS Computer searches were conducted in Embase， PubMed， the Cochrane Library， CNKI and health technology assessment （HTA） official website from their inception to October 1st 2024 to collect HTA report， systematic review/ meta-analysis and pharmacoeconomic study on tirzepatide for the treatment of T2DM or for weight management. After data extraction and quality evaluation， descriptive analysis was performed on the research results. RESULTS Totally 18 papers were included， including 14 systematic reviews/meta-analyses and 4 pharmacoeconomics studies， and no HTA report was retrieved. In terms of efficacy， most results showed that the tirzepatide 10 mg and 15 mg were significantly better than other glucagon-like peptide-1 （GLP-1） receptor agonists in reducing glycosylated hemoglobin， body weight， and waist circumference （P＜0.05）. In terms of safety， compared with other GLP-1 receptor agonists， tirzepatide did not increase the incidence of gastrointestinal-related adverse events （AE）， the incidence of AE of grade ≥3， or the incidence of severe hypoglycemia （P＞0.05）. However， tirzepatide 15 mg may significantly increased the incidence of hypoglycemia and the rate of discontinuation due to adverse reactions （P＜ 0.05）. In terms of cost-effectiveness， based on the background of foreign pharmacoeconomic studies， tirzepatide was more cost- effective compared to semaglutide and liraglutide in the treatment of T2DM or for weight management. CONCLUSIONS Tirzepatide at doses of 10 mg and 15 mg has good efficacy and safety for the treatment of T2DM and for long-term weight management. However， when using the 15 mg dose of tirzepatide， close monitoring is required due to the risk of hypoglycemia and discontinuation due to adverse reactions it may pose. Based on pharmacoeconomic studies conducted abroad results， tirzepatide exhibits economic advantages. |
| 期刊： | 2025年第36卷第09期 |
| 作者： | 谢泽宇；刘一诺；梁焯茹；曹耀华；郑桂梅；曹伟灵 |
| AUTHORS： | XIE Zeyu，LIU Yinuo，LIANG Zhuoru，CAO Yaohua，ZHENG Guimei，CAO Weiling |
| 关键字： | 替尔泊肽；2型糖尿病；肥胖；快速卫生技术评估 |
| KEYWORDS： | tirzepatide； diabetes mellitus type 2； obesity； rapid health technology assessment |
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