1.Argatroban in the treatment of acute ischemic stroke:a rapid health technology assessment
Zhijiang ZHUANG ; Qiang ZHANG ; Zhijia CHEN ; Lihong ZHANG
Chinese Journal of Pharmacoepidemiology 2024;33(5):549-560
Objective Rapid health technology assessment(HTA)was used to evaluate the efficacy,safety and economy of argatroban in the treatment of acute ischemic stroke,so as to provide evidence-based reference for clinical treatment decision making.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI,WanFang Data,VIP,SinoMed databases and HTA website were electronically searched to collect the HTA report,systematic review/Meta-analysis and pharmacoeconomic research of argatroban in the treatment of acute ischemic cerebral infarction from inception to February 6,2024.Two reviewers independently identified studies,extracted data,assessed the quality of included studies,and descriptively analyzed and summarised the results.Results A total of 21 articles were included,including 15 systematic reviews/Meta-analysis and 6 pharmacoeconomic studies.The analysis results of effectiveness showed that argatroban could improve the clinical effective rate,neurological deficit score compared with placebo,routine treatment,or other drugs(such as alteplase),but a few studies were inconsistent with the current results.The analysis results of safety showed that argatroban alone or in combination with other drugs did not increase the risk of systemic hemorrhage,intracranial hemorrhage,mortality and other adverse reactions compared with the control group,and had a favorable safety profile.The analysis results of pharmacoeconomic studies that argatroban combined with routine treatment or argatroban combined with urokinase had economic advantages.Conclusion Argatroban is generally effective and safe in the treatment of acute ischemic stroke,and it has economic advantages for patients to choose argatroban combined with routine treatment or urokinase treatment.