Tenecteplase in the treatment of acute ischemic stroke： a rapid health technology assessment

DENG Xiaomei; LI Huiting; MEN Peng; ZHANG Zhetao; ZHANG Jin; SHI Tianlu

doi:10.6039/j.issn.1001-0408.2024.20.17

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Tenecteplase in the treatment of acute ischemic stroke： a rapid health technology assessment

更新时间：2024-10-25

- Tenecteplase in the treatment of acute ischemic stroke： a rapid health technology assessment
- ZHONGGUO YAOFANG Vol. 35, Issue 20, Pages: 2541-2547(2024)
- 作者机构：
  
  1.中国科学技术大学附属第一医院（安徽省立医院）药学部，合肥;230036
  2.精准药物制剂与临床药学安徽省重点实验室，合肥　230001
  3.北京大学第三医院药学部，北京　100191
  4.北京大学医学部药物评价中心，北京　100191
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2024.20.17
  CLC： R743.31;R956;R969.3
- Published：30 October 2024，
  
  Received：09 April 2024，
  
  Revised：22 September 2024，
- 稿件说明：
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邓晓媚,李会婷,门鹏等.替奈普酶治疗急性缺血性脑卒中的快速卫生技术评估 ^Δ[J].中国药房,2024,35(20):2541-2547.

DENG Xiaomei,LI Huiting,MEN Peng,et al.Tenecteplase in the treatment of acute ischemic stroke： a rapid health technology assessment[J].ZHONGGUO YAOFANG,2024,35(20):2541-2547.
邓晓媚,李会婷,门鹏等.替奈普酶治疗急性缺血性脑卒中的快速卫生技术评估 ^Δ[J].中国药房,2024,35(20):2541-2547. DOI： 10.6039/j.issn.1001-0408.2024.20.17.

DENG Xiaomei,LI Huiting,MEN Peng,et al.Tenecteplase in the treatment of acute ischemic stroke： a rapid health technology assessment[J].ZHONGGUO YAOFANG,2024,35(20):2541-2547. DOI： 10.6039/j.issn.1001-0408.2024.20.17.

摘要

目的

评价替奈普酶治疗缺血性脑卒中的有效性、安全性和经济性，为临床合理用药和相关决策提供依据。

方法

系统检索PubMed、Cochrane图书馆、中国知网、万方数据以及卫生技术评估机构等官方网站，收集替奈普酶治疗急性缺血性脑卒中的系统评价/Meta分析、药物经济学研究和卫生技术评估报告，检索时限均为建库起至2024年6月30日。提取资料和评价质量后，对纳入研究的结果进行描述性分析。

结果

共纳入31篇文献，包括28篇系统评价/Meta分析和3篇药物经济学研究。有效性方面，与阿替普酶相比，替奈普酶（0.25 mg/kg）可显著提高患者的早期神经功能改善率，且在90 d优良神经功能预后率、90 d良好神经功能预后率及血管再通率方面均不劣于阿替普酶。安全性方面，与阿替普酶相比，替奈普酶不会增加出血发生率、症状性颅内出血发生率、3个月全因死亡率及颅内出血发生率。经济性方面，国外研究结果显示，替奈普酶较阿替普酶具有经济学优势。

结论

与阿替普酶相比，替奈普酶治疗急性缺血性脑卒中的有效性和安全性均较好，且具有经济学优势。

Abstract

OBJECTIVE

To assess the efficacy， safety and cost-effectiveness of tenecteplase in the treatment of acute ischemic stroke， and to provide a basis for clinical rational drug use and related decision-making.

METHODS

The related literature in the PubMed， the Cochrane Library， CNKI， Wanfang data and health technology assessment （HTA） databases were searched from the establishment of the database to June 30th， 2024. Systematic reviews/meta-analyses， pharmacoeconomic studies and HTA reports on tenecteplase in the treatment of acute ischemic stroke were collected. After data extraction and quality assessment， descriptive analysis of the included studies was carried out.

RESULTS

A total of 31 articles were included， involving 28 systematic reviews/meta-analysis and 3 pharmacoeconomic studies. In terms of effectiveness， compared with alteplase， tenecteplase （0.25 mg/kg） could significantly increase the early neurological improvement； the 90 d excellent neurological recovery rate， 90 d good neurological recovery rate， and recanalization were not inferior to alteplase. For safety， compared with alteplase， tenecteplase did not increase the incidence of hemorrhage， symptomatic intracranial hemorrhage， 3-month mortality， or intracranial hemorrhage. In terms of cost-effectiveness， foreign research results showed that tenecteplase had economic advantages over alteplase.

CONCLUSIONS

Compared with alteplase， tenecteplase is effective and safe in the treatment of acute ischemic stroke， and it is cost-effective.

关键词

替奈普酶急性缺血性脑卒中快速卫生技术评估有效性安全性经济性

Keywords

acute ischemic strokerapid health technology assessmenteffectivenesssafetycost-effectiveness

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