基于大规模真实世界数据的人促红细胞生成素与罗沙司他治疗肾性贫血的比较性研究OA
Comparative Study of Human Erythropoietin and Roxadustat in the Treatment of Renal Anemia Based on Large-Scale Real-World Data
目的:基于大规模真实世界临床数据,对比分析人促红细胞生成素与罗沙司他治疗肾性贫血的疗效和经济性,为临床用药选择及医保精细化管理提供循证依据.方法:收集 2022 年 12 月至 2025 年 6 月全国 3 个统筹地区 83 家医疗机构的肾性贫血患者医保结算清单与住院电子病历数据,纳入采用人促红细胞生成素或罗沙司他进行治疗的患者.分析真实临床中单一用药和切换用药模式分布;单一用药模式下,以血红蛋白增长率、治疗有效率、血红蛋白应答率和血红蛋白达标率评估疗效,以次均药品费用和住院总费用评估经济性.结果:共纳入 10 916 例患者,其中单一使用人促红细胞生成素治疗者占 61.35％(6 697 例),单一使用罗沙司他治疗者占15.52％(1 694 例),两者切换使用者占23.13％(2 525 例).疗效方面,人促红素组在血红蛋白增长率(16.31％vs.10.46％)、治疗有效率(73.57％vs.68.92％)、血红蛋白应答率(36.34％vs.28.41％)及血红蛋白达标率(21.24％vs.17.75％)方面均高于罗沙司他组,差异均有统计学意义(P<0.05).经济性方面,人促红素组的次均药品费用(127 元 vs.752 元)和住院总费用(7 980 元 vs.8 437 元)均低于罗沙司他组,差异均有统计学意义(P<0.001).多元回归分析结果与上述结果一致.结论:基于大规模真实世界数据回顾性队列研究,在统计学上揭示,当前阶段人促红细胞生成素仍是治疗肾性贫血主要用药,在疗效方面有一定综合优势,经济性方面的优势明显.罗沙司他作为创新口服药已在临床中逐步应用,为肾性贫血治疗提供了新的选择.
OBJECTIVE:To compare and analyze the efficacy and economy of erythropoietin and roxadustat in the treatment of renal anemia based on large-scale real-world clinical data,and to provide evidence-based basis for clinical treatment selection and refined health insurance management.METHODS:Medical insurance settlement lists and inpatient electronic medical records of renal anemia patients were collected from 83 medical institutions across three coordinated regions in China from Dec.2022 to Jun.2025,samples treated with either human erythropoietin or roxadustat were enrolled.Descriptive statistics were used to analyze the distribution of monotherapy and switching medication patterns in real-world clinical practice.Under the monotherapy pattern,efficacy was assessed by hemoglobin growth rate,treatment effectiveness rate,hemoglobin response rate,and hemoglobin target achievement rate,while economic outcomes were evaluated using average drug cost per admission and total hospitalization cost.RESULTS:A total of 10 916 patients were included.Regarding treatment patterns,61.35％of patients(6 697 cases)received erythro-poietin as monotherapy,15.52％(1 694 cases)were treated with roxadustat alone,while 23.13％(2 525 cases)underwent switching therapy between these two agents.Regarding efficacy,the human erythropoietin group showed higher hemoglobin growth rate(16.31％vs.10.46％),effective rate(73.57％vs.68.92％),hemoglobin response rate(36.34％vs.28.41％)and hemoglobin target achievement rate(21.24％vs.17.75％)than those in the roxadustat group after treatment,with statistically significant differences(P<0.05).In terms of economic outcomes,the erythropoietin group had significantly lower average drug costs per hospitalization(127 RMB vs.752 RMB)and total hospitalization costs(7 980 RMB vs.8 437 RMB)than those in the roxadustat group,with statistically significant differences(P<0.001).Multivariate regression analysis yielded results consistent with the above conclusions.CONCLUSIONS:Based on large-scale real-world retrospective cohort data,human erythropoietin remains the main treatment for renal anemia,showing certain advantages in efficacy and clear economic benefits.As an innovative oral agent,roxadustat has been increasingly used in clinical practice and offers an additional therapeutic option for renal anemia.
刘喜恩;金松;唐建宇;张欢;吴及
清华大学电子工程系,北京 100084贵阳市医疗保障局,贵阳 550081九江市医疗保障局,江西 九江 332899北京惠及智医科技有限公司研究院,北京 100192清华大学电子工程系,北京 100084||清华大学人工智能学院,北京 100084||清华大学北京信息科学与技术国家研究中心,北京 100084
医药卫生
人促红细胞生成素罗沙司他肾性贫血临床用药模式疗效经济性
Human erythropoietinRoxadustatRenal anemiaClinical medication patternEfficacyEconomical efficiency
《中国医院用药评价与分析》 2026 (3)
261-265,269,6
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