系统Janus激酶抑制剂治疗特应性皮炎的药品遴选实践

Practice of Drug Selection of Systemic Janus Kinase Inhibitors for Atopic Dermatitis

关键词:  JAK抑制剂  阿布昔替尼  乌帕替尼  巴瑞替尼  特应性皮炎  药品遴选  

Key words:  JAK inhibitors  abrocitinib  upadacitinib  baricitinib  atopic dermatitis  drug selection  

摘要:

目的 药物遴选阿布昔替尼、乌帕替尼、巴瑞替尼等可用于治疗特应性皮炎的JAK抑制剂,为医院决策者遴选和临床合理使用提供循证依据。 方法 以《中国医疗机构药品评价与遴选快速指南(第二版)》为依据,并参考药品说明书、临床诊疗指南及万方、维普、知网、PubMed、Embase、The Cochrane Library等数据库相关文献,收集阿布昔替尼、乌帕替尼和巴瑞替尼在AD治疗方面的相关信息,从药学特性、有效性、安全性、经济性及其他属性等5个维度进行量化评分,并根据评分结果划分推荐级别。 结果 最终3种Janus激酶抑制剂的评分分别为：阿布昔替尼71.69分,乌帕替尼77.50分,巴瑞替尼66.16分,阿布昔替尼及乌帕替尼评分在70分以上,推荐进入医疗机构目录,巴瑞替尼评分在60~70分,根据临床是否有替代治疗药物,弱推荐或不推荐进入医疗机构目录。乌帕替尼在有效性方面优势较强,评分为25.00分；在药学特性、安全性、经济性及其他属性上3种JAK抑制剂剂优势均不明显,评分仅相差1~2分。 结论 本次药品快速遴选实践可为医疗机构开展药品评价与遴选提供实践经验,同时为临床在AD患者选择JAK抑制剂口服制剂时提供循证依据。

Abstract:

ABSTRACT: OBJECTIVE Drug selection of JAK inhibitors for the treatment of AD provides an evidence-based basis for the hospital policy-makers’ selection and clinical rational use. METHODS According to the “A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions (the Second Edition)”, and referring to the drug instructions, clinical diagnosis and treatment guidelines and relevant literatures in Wanfang, VIP, CNKI, PubMed, Embase and The Cochrane Libraray databases, relevant information on the treatment of AD with Abrocitinib, Upadacitinib and Baricitinib was collected, and quantitative scoring was performed from five dimensions including pharmaceutical properties, efficacy, safety, economy and other attributes, and the recommendation level was divided according to the scoring results. RESULTS The final scores of three JAK inhibitors were 71.69 points for Abrocitinib, 77.50 points for Upadacitinib and 66.16 points for Baricitinib. The scores of Abrocitinib and Upadacitinib were more than 70 points, and it is recommended to enter the drug use catalog of medical institutions. The scores of Baricitinib is between 60 and 70 points, and it is weakly recommended or not recommended to enter the drug use catalog of medical institutions. Upadacitinib had a strong advantage in efficacy, with a score of 25.00; none of the three JAK inhibitors had significant advantages in pharmaceutical properties, safety, economy, and other attributes, with scores differing by only 1 to 2 points. CONCLUSION The practice of drug selection can provide practical experience for medical institutions to evaluate and select drug, and provide evidence-based medical evidence for selection of oral JAK inhibitors for AD patients.