论文部分内容阅读
通过纳入随机对照试验、随机交叉试验、自身前后对照研究、队列研究和病例报告,评价伏立康唑对联合使用药物的药代动力学参数和安全性的影响。系统检索Pub Med、Embase、Cochrane Library、Clinicaltrials.gov、中国知网、万方和中国生物医学文献数据库,检索时间从建库至2016年1月。本文采用改良的偏倚风险工具评价药代动力学随机交叉研究和自身前后对照研究的质量,用Cochrane Library和Cochrane Reviewer’s handbook中的偏倚风险工具评价随机对照试验研究和非随机对照试验研究的质量。提取药物与伏立康唑联合使用前后,药物的曲线下面积(AUC),血药谷浓度(C_(min))和峰浓度(C_(max))等药代动力学参数及安全性数据(Safety)。必要时,用荟萃分析合并结果。总共纳入了41篇研究,包括17篇随机交叉试验,3篇随机对照试验,13篇自身前后对照研究,1篇队列研究和7篇病例报告。研究中评价了伏立康唑对12类药物的影响,包括阿片类镇痛药、抗精神病药、抗艾滋病药、免疫抑制剂、口服避孕药、地高辛、华法林、口服降糖药、降压药、降脂药和细胞毒化疗药。根据本研究的结果,伏立康唑对替利定、丁丙诺啡、依托考昔、美洛昔康、文拉法辛、咪达唑仑、唑吡坦、依曲韦林和西罗莫司的影响与伏立康唑说明书不一致。本系统评价展示了伏立康唑对联合使用药物的药代动力学参数和安全性的影响。
The effects of voriconazole on the pharmacokinetic parameters and safety of the combination were evaluated by including randomized controlled trials, randomized crossover trials, self-prioritized control studies, cohort studies, and case reports. PubMed, Embase, Cochrane Library, Clinicaltrials.gov, CNKI, Wanfang and China Biomedical Literature Database were searched systematically. The search time was from the database to January 2016. In this paper, a modified bias risk tool was used to evaluate the quality of randomized cross-pharmacokinetic studies and their own prior-to-postcontrol study and the quality of randomized controlled trials and non-randomized controlled trials evaluated using the risk of bias tool in the Cochrane Library and the Cochrane Reviewer’s handbook. Pharmacokinetic parameters such as AUC, C min and C max before and after the combination of voriconazole with the drug were extracted and safety data were obtained. Meta-analysis of the combined results, if necessary. A total of 41 studies were included, including 17 randomized crossover trials, 3 randomized controlled trials, 13 self-prior and controlled studies, 1 cohort study, and 7 case reports. The study evaluated the effects of voriconazole on 12 classes of drugs, including opioid analgesics, antipsychotics, anti-AIDS drugs, immunosuppressive agents, oral contraceptives, digoxin, warfarin, oral hypoglycemic agents, Drugs, lipid-lowering drugs and cytotoxic chemotherapy drugs. Based on the results of this study, the effects of voriconazole on teiLingDing, buprenorphine, etoricoxib, meloxicam, venlafaxine, midazolam, zolpidem, etravirine and sirolimus The effect is inconsistent with voriconazole instructions. This systematic review demonstrates the effect of voriconazole on pharmacokinetic parameters and safety of the combination.