Rapid Health Technology Assessment of Edoxaban in the Treatment of Cancer-Associated Venous Thromboembolism
Objective To evaluate the efficacy,safety,and cost-effectiveness of edoxaban in the treatment of cancer-associated venous thromboembolism(CAVTE).Methods PubMed,The Cochrane Library,CRD Web,CNKI,WanFang database,and official websites of domestic and foreign health technology assessment(HTA)institutions were searched from their inception to August 31,2023.Two reviewers independently screened the literature and extracted data according to inclusion and exclusion criteria.The HTA checklist and AMSTAR2 or CHEERS 2022 scales were used to evaluate the quality of the included literature.Descriptive analysis was used to analyze and summarize the extracted research content.Results A total of 514 relevant studies were retrieved,and nine systematic reviews/Meta-analyses and four pharmacoeconomic studies were ultimately included.The results showed that in terms of effectiveness,the efficacy of edoxaban in treating CAVTE and reducing the recurrence of venous thromboembolism was better than that of warfarin(P＜0.05),which was comparable to that of low molecular weight heparin(LMWH),rivaroxaban,and apixaban(P＞0.05);the efficacy of edoxaban in reducing pulmonary embolism recurrence was comparable to that of LMWH(P＞0.05),but the efficacy of edoxaban in reducing deep vein thrombosis recurrence was better than that of LMWH(P＜0.05).In terms of safety,edoxaban had a higher risk of major bleeding than LMWH(P＜0.05),but it had a similar risk to warfarin,apixaban and rivaroxaban(P＞0.05);edoxaban had a lower risk of clinically relevant non-major bleeding than warfarin(P＜0.05),but it had a similar risk to LMWH,apixaban and rivaroxaban(P＞0.05);edoxaban had a higher risk of clinically relevant bleeding than LMWH(P＜0.05),and had a lower risk than rivaroxaban(P＜0.05),but had a similar risk to apixaban(P＞0.05).In terms of economy,foreign researches showed that edoxaban had a cost-utility advantage in treating CAVTE than LMWH.Conclusion Edoxaban is effective and safe in the treatment of CAVTE,and foreign researches suggested that it is economical.However,there is no domestic pharmacoeconomic research.
edoxabancancer-associated venous thromboembolismrapid health technology assessmenteffectivenesssafetyeconomy
万方数据
维普
