Objective To systematically review the health economic evaluation studies of medicines for the treatment of acute myeloid leukemia (AML). MethodsThe PubMed, EMbase, Cochrane Library, CBM, CNKI, and WanFang Data, as well as the CRD database specifically for health economics were electronically searched from inception to June 2022, and related journals in the field of health economics and the websites of HTA institutions in various countries were manually searched. The quality of the studies was assessed using the CHEERS checklist. The basic characteristics of health economics evaluation publications were summarized, the quality of model structures and methodologies was assessed and economic evaluation results were compared among different treatments. Results A total of 17 studies were included, and cost-effectiveness analyses were conducted from the perspectives of the health system, patients, the whole society, and medical insurance payers. The economic evaluation models were relatively unified, but there were differences in methods and results reporting, and the quality needed to be improved. The research objects were mainly the comparison of hypomethylating agents, targeted medicine and traditional chemotherapy regimens, as well as the comparison of different chemotherapy combinations and different drug dosages. Conclusion Real-world studies are mainly focused on traditional chemotherapy regimens, and model-based health economic evaluations, such as Markov models, are more frequently applied to newly developed targeted drugs and demethylation drugs. Among all treatments, the chemotherapy regimens including cytarabine, midostaurin, and decitabine are found to be more cost-effective.
ObjectiveTo systematically review the efficacy and safety of dienogest in the treatment of endometriosis. MethodsThe PubMed, Embase, Cochrane Library, CBM, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of dienogest for the treatment of endometriosis from inception to February 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. ResultsA total of 20 RCTs, involving 2 826 patients were included. Meta-analysis showed that compared with gonadotropin-releasing hormone agonist (GnRH-a), dienogest had similar efficacy. Compared with placebo, dienogest was more effective in reducing endometriosis-related pelvic pain. Compared with oral contraceptives, dienogest performed better in relieving endometriosis-related pelvic pain and improving recurrence and pregnancy rates. Compared with other drugs (such as non-steroidal anti-inflammatory drugs, dydrogesterone, etc.), dienogest could gradually reduce the pain. In terms of safety, dienogest could reduce bone density damage and hot flashes in patients with endometriosis compared with the control group. ConclusionCurrent evidence shows that dienogest is effective and safely tolerated in the treatment of endometriosis. Due to the limitations of the quantity and quality of included studies, the above conclusion needs to be verified by more high-quality studies.