使用冠状动脉的风险分层和semaglutide治疗的潜在益处:一个成本效益建模研究
Sai Rahul Ponnana1, Tong Zhang1, Santosh Kumar Sirasapalli1
1Case School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Diabetes, obesity & metabolism
|February 2, 2026
概括
冠状动脉 (CAC) 评分有助于预测主要不良心血管事件 (MACE) 风险. 这项研究发现,对于具有较高CAC分数的个体来说,塞马格卢提德治疗更具成本效益,这表明CAC可以指导治疗决策.
科学领域:
- 心血管医学 心血管医学
- 药物经济学 药物经济学
- 肥胖管理 肥胖管理
背景情况:
- 冠状动脉 (CAC) 评分有效地分层了主要不良心血管事件 (MACE) 的风险.
- 塞马格卢提德是一种高效的抗肥胖药物,但其高成本限制了可获得性.
- 与CAC分数相关的塞马格卢提德治疗的成本效益需要研究.
研究的目的:
- 为了评估不同冠状动脉 (CAC) 评分组的塞马格卢提德治疗的成本效益.
- 根据CAC定义的心血管风险来确定塞马格卢提德的临床益处和经济价值.
主要方法:
- 使用了来自38,058名符合SELECT标准的CLARIFY注册表参与者的数据,按CAC得分分层 (0,1-99,100-399,≥400).
- 估计MACE风险使用多变量调整的Cox比例危险模型.
- 开发了终身马尔科夫模型来模拟西马格卢提德治疗,计算治疗所需的数量 (NNT) 和增量成本效益比率 (ICER).
主要成果:
- 较高的CAC分数与MACE风险增加相关,包括心肌梗塞,心力衰竭,中风和全因死亡率.
- 在3.3年内,塞马格卢提德治疗显示了CAC=0的151和CAC≥400的34的潜在MACE NNT值.
- 随着CAC得分的提高,塞马格卢提德的增量成本效益比 (ICER) 显著下降,从CAC=0的625,863美元/QALY降至CAC≥400的168,666美元/QALY.
结论:
- 冠状动脉 (CAC) 评分可以作为一种有价值的工具,用于评估在肥胖个体中终身塞马格卢提德治疗的潜在临床益处和成本效益.
- CAC评分可能有助于个性化治疗策略,以优化治疗结果和资源配置.
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