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【文摘发布】2型糖尿病应用阿托伐他汀进行心血
2型糖尿病应用阿托伐他汀进行心血管疾病一级预防的效价比——阿托伐他汀糖尿病协作研究(CARDS)结果
Author：Raikou M, McGuire A, Colhoun HM, Betteridge DJ, Durrington PN, Hitman GA, Neil HA, Livingstone SJ, Charlton-Menys V, Fuller JH; CARDS Investigators.
Resource: Diabetologia. 2007 Apr;50(4):733-40. Epub 2007 Jan 31.
Abstract：
AIMS/HYPOTHESIS: Title：Cost-effectiveness of primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes: results from the Collaborative Atorvastatin Diabetes Study (CARDS)
标题：2型糖尿病应用阿托伐他汀进行心血管疾病一级预防的效价比——阿托伐他汀糖尿病协作研究(CARDS)结果
作者：Raikou M, McGuire A, Colhoun HM, Betteridge DJ, Durrington PN, Hitman GA, Neil HA, Livingstone SJ, Charlton-Menys V, Fuller JH; CARDS Investigators.
来源: Diabetologia. 2007 Apr;50(4):733-40. Epub 2007 Jan 31.
Abstract：
摘要：
AIMS/HYPOTHESIS: We estimated the cost-effectiveness of atorvastatin treatment in the primary prevention of cardiovascular disease in patients with type 2 diabetes using data from the Collaborative Atorvastatin Diabetes Study (CARDS).
目的/假说：应用来自阿托伐他汀糖尿病协作研究(CARDS)的资料评价2型糖尿病患者应用阿托伐他汀进行心血管疾病一级预防的效价比。
SUBJECTS AND METHODS: A total of 2,838 patients, who were aged 40 to 75 years and had type 2 diabetes without a documented history of cardiovascular disease and without elevated LDL-cholesterol, were recruited from 32 centres in the UK and Ireland and randomly allocated to atorvastatin 10 mg daily (n = 1,428) or placebo (n = 1,410). These subjects were followed-up for a median period of 3.9 years. Direct treatment costs and effectiveness were analysed to provide estimates of cost per endpoint-free year over the trial period for alternative definitions of endpoint, and of cost per life-year gained and cost per quality-adjusted life-year (QALY) gained over a patient's lifetime.
对象与方法：来自英国和爱尔兰32个中心的、无心血管疾病记录史、无LDL胆固醇升高、年龄在40岁至75岁之间共2838例糖尿病患者，随机分配至阿托伐他汀10mg/日组（n=1428）或安慰剂组（n=1410）。这些患者的平均随访时间为3.9年。分析直接治疗费用和疗效去评价就终末事件的其它定义而言的整个试验期间无终末事件年费用、寿命延长年费用及患者一生中生活质量调整后的寿命（QALY）延长年费用 。
RESULTS: Over the trial period, the incremental cost-effectiveness ratio (ICER) was estimated to be pound7,608 per year free of any CARDS primary endpoint; the ICER was calculated to be pound4,896 per year free of any cardiovascular endpoint and pound4,120 per year free of any study endpoint. Over lifetime, the incremental cost per life-year gained was pound5,107 and the cost per QALY was pound6,471 (costs and benefits both discounted at 3.5%).
结果：整个试验期间，估计增加的效价比（ICER）：无任何CARDS一级终点的为7608英镑/年，无心血管终点的为4896英镑/年，无任何研究终点的为4120英镑/年。整个一生中，寿命延长年增加费用为5107英镑，每OALY增加费用为6471英镑（费用与疗效均减少3.5%）。
CONCLUSIONS/INTERPRETATION: Primary prevention of cardiovascular disease with atorvastatin is a cost-effective intervention in patients with type 2 diabetes, with the ICER for this intervention falling within the current acceptance threshold ( pound20,000 per QALY) specified by the National Institute for Health and Clinical Excellence (NICE).
结论/解释：2型糖尿病患者中阿托伐他汀一级预防心血管疾病是一项效价干预，在目前可接受的、国家健康与临床研究所指定的最高费用（20000英镑/QALY）范围内ICER随干预下降。
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作者:admin@医学,生命科学 2010-12-07 05:11
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