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SGLT-2抑制剂治疗2型糖尿病的快速卫生技术评估
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| 篇名： | SGLT-2抑制剂治疗2型糖尿病的快速卫生技术评估 |
| TITLE： | Rapid health technology assessment of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus |
| 摘要： | 目的 评价钠-葡萄糖共转运蛋白2（SGLT-2）抑制剂治疗2型糖尿病（T2DM）的安全性、有效性及经济性。方法检索PubMed、CochraneLibrary、Embase、中国知网等数据库及相关卫生技术评估（HTA）官方网站，收集SGLT-2抑制剂（卡格列净、达格列净及恩格列净等12种）治疗T2DM的HTA报告、系统评价/Meta分析和药物经济学研究，检索时限为建库/建站起至2025年1月28日。在文献筛选、资料提取并对文献质量进行评价后，对纳入研究的结果进行描述性分析。结果共纳入38篇文献，包括30篇系统评价/Meta分析、4篇药物经济学研究及4篇HTA报告。有效性方面，大部分研究结果显示，与其他SGLT-2抑制剂相比，卡格列净可有效控制血糖、体重及血压；恩格列净可有效降低全因病死率。安全性方面，与其他SGLT-2抑制剂相比，恩格列净的总体不良反应及心血管死亡发生风险较低，卡格列净的低血糖发生风险较高，达格列净的尿路感染发生风险较高。经济学方面，相较于达格列净及卡格列净，恩格列净具有经济学优势；卡格列净较达格列净更具经济学优势。结论SGLT-2抑制剂治疗T2DM需进行个体化选择，针对心血管高风险人群推荐卡格列净；恩格列净的总体安全性最佳；达格列净慎用于尿路感染高风险患者。基于国外经济学证据，恩格列净具有经济学优势，未来需开展我国卫生体系下的药物经济学研究。 |
| ABSTRACT： | OBJECTIVE To evaluate the safety， efficacy， and cost-effectiveness of sodium-glucose co-transporter 2 （SGLT-2） inhibitors for treating type 2 diabetes mellitus （T2DM）. METHODS Retrieved databases such as PubMed， Cochrane Library， Embase， CNKI， as well as relevant health technology assessment （HTA） official websites， HTA reports， systematic review/meta- analysis and pharmacoeconomic studies about SGLT-2 inhibitors （including 12 types such as canagliflozin， dapagliflozin， and empagliflozin） in the treatment of T2DM were collected from the inception to January 28， 2025. After literature screening data extraction and quality assessment， a descriptive analysis was conducted on the results of the included studies. RESULTS A total of 38 articles were included， comprising 30 systematic reviews/meta-analyses， 4 pharmacoeconomic studies， and 4 HTA reports. In terms of effectiveness， most research results showed that canagliflozin was effective in controlling blood glucose， reducing body weight， and lowering blood pressure compared to other SGLT-2 inhibitors， while empagliflozin could effectively reduce all-cause mortality. In terms of safety， compared with other SGLT-2 inhibitors， empagliflozin has a lower overall adverse event rate and cardiovascular death risk， canagliflozin presented a higher risk of hypoglycemia， and dapagliflozin had a higher risk of urinary tract infections. In terms of economics， empagliflozin possessed greater economic advantages over both dapagliflozin and canagliflozin， while canagliflozin offered more benefits than dapagliflozin. CONCLUSIONS The selection of SGLT-2 inhibitors for the treatment of T2DM should be individualized. Canagliflozin is recommended for patients with high cardiovascular risk. Empagliflozin boasts the best overall safety profile. Dapagliflozin should be used with caution in patients at high risk of urinary tract infections. Based on foreign economic evidence， empagliflozin has economic advantages. In the future， drug economic studies under the Chinese health system need to be conducted. |
| 期刊： | 2025年第36卷第23期 |
| 作者： | 潘慧敏；王钰博；单慧亭；陈迹；杨建华 |
| AUTHORS： | PAN Huimin，WANG Yubo，SHAN Huiting，CHEN Ji，YANG Jianhua |
| 关键字： | SGLT-2抑制剂；2型糖尿病；快速卫生技术评估；卡格列净；达格列净；恩格列净 |
| KEYWORDS： | SGLT-2 inhibitors； type 2 diabetes mellitus； rapid health technology assessment； canagliflozin； dapagliflozin； |
| 阅读数： | 4 次 |
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