玛巴洛沙韦治疗流行性感冒的系统评价再评价
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R183.3 R978.7

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河南省医学科技攻关计划联合共建项目(LHGJ20200622)


Baloxavir marboxil in the treatment of influenza: a re-assessment of systematic review
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    目的 对玛巴洛沙韦治疗流行性感冒(简称流感)的Meta分析/网状Meta分析进行再评价,以期为该药的临床应用提供循证参考。方法 系统检索PubMed、Embase、Cochrane Library、中国知网、万方和维普数据库中玛巴洛沙韦治疗流感的Meta分析/网状Meta分析,检索时限为建库至2023年12月11日。根据纳入与排除标准筛选文献,提取纳入文献信息,分别使用AMSTAR-2量表、PRISMA声明、GRADE系统分别对纳入文献的方法学质量、报告质量与证据质量进行评价。结果 共纳入7篇Meta分析/网状Meta分析,结果显示,在流感症状缓解时间上,玛巴洛沙韦疗效不劣于奥司他韦、帕拉米韦、扎那米韦;在用药后48 h流感病毒滴度降低水平上,玛巴洛沙韦优于奥司他韦、扎那米韦;在安全性方面,玛巴洛沙韦比奥司他韦在药物相关的不良事件风险更低,与帕拉米韦和扎那米韦相当。AMSTAR-2量表方法学质量评价结果整体偏低,2篇为低级,5篇为极低级;PRISMA得分在15.5~22分,整体报告质量中等,得分>21分的有2篇文献,报告相对完整;得分15~21分的有5篇文献,报告具有一定的缺陷。GRADE证据质量分级结果显示,纳入的199个结局指标中4个指标证据质量为高级,49个指标证据质量为中级,118个指标证据质量为低级,28个指标证据质量为极低级。结论 玛巴洛沙韦在缓解流感症状时间上与神经氨酸酶抑制剂相当,在降低流感病毒滴度水平上优于奥司他韦和扎那米韦,药物不良事件发生风险(尤其恶心风险)比奥司他韦更低。

    Abstract:

    Objective To re-assess the Meta-analyses/network Meta-analyses on baloxavir marboxil in the treatment of influenza, and provide evidence-based reference for clinical use of baloxavir marboxil. Methods Meta-analyses/network Meta-analyses on baloxavir marboxil in the treatment of influenza were retrieved from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases, with retrieval time from the inception of each database to December 11, 2023. Literatures were screened according to the inclusion and exclusion criteria. Information of included literatures was extracted, and the methodological quality, reporting quality and evidence quality of the included literatures were assessed by assessment of multiple systematic reviews 2 (AMSTAR-2) scale, preferred reporting items for systematic reviews and Meta-analyses (PRISMA) statement, as well as grading of recommendations, assessment, development, and evaluation (GRADE) system, respectively. Results A total of 7 Meta-analyses/network Meta-analyses were included. The results showed that in terms of alleviation time of influenza symptoms, the efficacy of baloxavir marboxil was not inferior to oseltamivir, peramivir, and zanamivir. In terms of the decrease in influenza virus titer 48 hours after medication, baloxavir marboxil was superior to oseltamivir and zanamivir. In terms of safety, baloxavir marboxil had a lower risk of drug-related adverse events than oseltamivir, and was comparable to peramivir and zanamivir. The overall assessment result of methodological quality of AMSTAR-2 scale was relatively low, with 2 literatures being classified as low-level and 5 as extremely low-level. PRISMA scores ranged 15.5-22. The quality of overall report was moderate. Two lite-ratures were scored >21, and the reports were relatively complete. There were 5 literatures with scores ranging 15-21, and the reports had certain deficiencies. The GRADE evidence quality grading results showed that among the included 199 outcome indicators, 4 indicators were high-level evidence, 49 were moderate-level evidence, 118 indicators were low-level evidence, and 28 indicators were extremely low-level evidence. Conclusion Baloxavir marboxil is comparable to neuraminidase inhibitors in the alleviation time of influenza symptoms, superior to oseltamivir and zanamisvir in decreasing virus titer, and has a lower risk of adverse drug events (especially nausea) than oseltamivir.

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王瑞丽,陶兴茹,海莉丽.玛巴洛沙韦治疗流行性感冒的系统评价再评价[J]. 中国感染控制杂志,2025,24(7):912-922. DOI:10.12138/j. issn.1671-9638.20256497.
WANG Ruili, TAO Xingru, HAI Lili. Baloxavir marboxil in the treatment of influenza: a re-assessment of systematic review[J]. Chin J Infect Control, 2025,24(7):912-922. DOI:10.12138/j. issn.1671-9638.20256497.

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  • 收稿日期:2024-05-16
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  • 在线发布日期: 2025-07-28
  • 出版日期: 2025-07-28