中国药房2025，Vol.36Issue(10)：1260-1265,6.DOI:10.6039/j.issn.1001-0408.2025.10.19
阿哌沙班预防和治疗肿瘤相关静脉血栓栓塞症的快速卫生技术评估
Apixaban for the prevention and treatment of cancer-associated venous thromboembolism:a rapid health technology assessment
摘要
Abstract
OBJECTIVE To evaluate the efficacy,safety and cost-effectiveness of apixaban in the prevention and treatment of cancer-associated venous thromboembolism(CA-VTE),and provide evidence-based reference for clinical treatment.METHODS Retrieved from PubMed,the Cochrane Library,CNKI,Wanfang,VIP database and other websites of health technology assessment(HTA),systematic review/meta-analysis,pharmacoeconomic studies and HTA reports of apixaban in the prevention and treatment of CA-VTE were collected.After data extraction and quality evaluation,the results of the included study were analyzed descriptively.RESULTS A total of 23 literatures were included,involving 16 systematic review/meta-analysis and 7 pharmacoeconomic studies.In terms of efficacy,compared with placebo,prophylactic use of apixaban could significantly reduce the incidence of venous thromboembolism(VTE)in outpatient adult cancer patients receiving chemotherapy(P＜0.05).Compared with low-molecular weight heparin(LMWH),rivaroxaban and warfarin,there were no statistically significant differences in the incidence of VTE for apixaban(P＞0.05);nevertheless,apixaban was ranked as the most preferable choice.For the treatment of patients with CA-VTE,compared with warfarin,apixaban could significantly reduce the recurrence rate of VTE(P＜0.05).While compared with patients treated with LMWH,rivaroxaban,edoxaban and dabigatran,there were no statistically significant differences in the recurrence rates of VTE,deep venous thrombosis and pulmonary embolism among patients using apixaban(P＞0.05).In terms of safety,compared with placebo,prophylactic use of apixaban showed a higher occurrence of major bleeding in outpatient adult cancer patients receiving chemotherapy(P＜0.05),while compared with patients treated with LMWH,rivaroxaban,and warfarin,there were no statistically significant differences in the incidence of major bleeding among patients using apixaban(P＞0.05);despite this,apixaban was ranked as the most favorable option.For the treatment of patients with CA-VTE,compared with dalteparin,the incidence of major bleeding and all-cause mortality of apixaban were similar(P＞0.05),while the incidence of clinically relevant non-major bleeding(CRNMB)was higher(P＜0.05).Compared with edoxaban,the incidence of major bleeding of apixaban was reduced significantly(P＜0.05),while there was no significant difference in the incidence of CRNMB,the incidence of clinically relevant bleeding and all-cause mortality(P＞0.05).Compared with rivaroxaban,warfarin and dabigatran,there were no significant differences in the incidence of major bleeding,the incidence of CRNMB,the incidence of clinically relevant bleeding and all-cause mortality(P＞0.05).In terms of cost-effectiveness,the researches in China showed that apixaban was cost-effective in preventing CA-VTE;foreign studies showed that apixaban was cost-effective in preventing and treating CA-VTE.CONCLUSIONS Apixaban is effective,safe and cost-effective in the prevention and treatment of CA-VTE.关键词
阿哌沙班/肿瘤/静脉血栓栓塞症/快速卫生技术评估Key words
apixaban/cancer/venous thromboembolism/rapid health technology assessment分类
医药卫生引用本文复制引用
王华玉,上官可可,王莹,李艳奎..阿哌沙班预防和治疗肿瘤相关静脉血栓栓塞症的快速卫生技术评估[J].中国药房,2025,36(10):1260-1265,6.基金项目
天津市科技计划项目(No.23JCZXJC00160) （No.23JCZXJC00160）
天津市卫生健康科技项目(No.TJWJ2024ZK002) （No.TJWJ2024ZK002）
天津医科大学第二医院青年科研基金项目(No.2023ydey30) （No.2023ydey30）
