A Study On The Risk-benefit Evaluation Of Various Drugs For Treatment Of Osteoarthritis Based On The BRAT And SMAA Models

Objective:To study the application of Brat framework and SMAA model in the evaluation of drug benefit risk,to provide an objective basis for the evaluation of drug value,to provide an effective reference for guiding the rational use of drugs,and to provide an analytical approach for monitoring the risk of adverse reactions.Provide data support for rational allocation of health resources.Methods:Using the literature research method,retrieving the database of Chinese Knowledge net(CNKI),Whipple,Wanfang,Pubmed,Cochrane,OVID,Springer,and so on,the paper summarizes the relevant literatures about the risk evaluation of drug benefit at home and abroad,and combs the methods and application of the risk evaluation of drug benefit at home and abroad,The research on the drug of osteoarthritis is combed,analysis,identify the subjects,sift into the benefit and risk indicators,and obtain the relevant research data,and analyze the literature data obtained by the screening standard by using the net meta analysis,and compare the benefit risk of non steroidal analgesic and anti-inflammatory drugs used in the treatment of osteoarthritis in different studies.The Brat model was used to summarize the collected data,and to evaluate the benefit risk of treating osteoarthritis with five kinds of drugs respectively and placebo.The SMAA model was used to summarize the collected data and evaluate the benefit risk of six kinds of drugs in treating osteoarthritis.Contents:To evaluate the effectiveness and risk of six drugs in treating osteoarthritis with Bayesian network meta analysis.The benefit risk of five drugs and placebo was evaluated by comparing the other five drugs with,using Brat model as a control drug.Using Smaa model,the comprehensive benefit risk evaluation of six kinds of osteoarthritis drugs in 10 clinical indexes were simulated with three different preference information.Results:Bayesian network meta-analysis results were as follows:(1)Treatment completion rate:Etoricoxib>ibuprofen>diclofenac>naproxen>celecoxib>Placebo;(2)12weekPainScore(V AS)Change:Etoricoxib>diclofenac>naproxen>celecoxib>ibuprofen>Placebo;(3)12 weeks Phys Func score changes:Etoricoxib>naproxen>ibuprofen>celecoxib>diclofenac>Placebo;(4)The incidence of total adverse reactions:naproxen>diclofenac>ibuprofen>Etoricoxib>celecoxib>Placebo;(5)The incidence of adverse reactions resulting from drug use:ibuprofen>naproxen and diclofenac>Etoricoxib>Celecoxib>Placebo>(6)Incidence of adverse reaction of the digestive system:naproxen>Ibuprofen>diclofenac>celecoxib>Placebo>Etoricoxib;(7)The incidence of heartache:placebo>ibuprofen>diclofenac>celecoxib>naproxen>Etoricoxib(8)The incidence of hypertensive reaction:diclofenac>ibuprofen>Etoricoxib>celecoxib>Placebo>naproxen;(9)Incidence of upper respiratory tract infections:naproxen>Etoricoxib>diclofenac>celecoxib>Placebo(10)Treatment failure rates:placebo>ibuprofen>celecoxib>Etoricoxib>naproxen>diclofenac.The results of Brat Model evaluation are as follows:(1)The effects of celecoxib and placebo were better than placebo in the treatment completion rate,Pain VAS score change,phys func score change,total adverse reaction rate,adverse reaction incidence,hypertension incidence,upper respiratory tract infection incidence,The incidence of adverse reaction of digestive system was higher than that of Placebo,(2)compared with placebo,diclofenac acid was better than placebo in treatment completion rate,Pain VAS score change,phys func score change,overall adverse reaction rate,drug-induced adverse reaction incidence,hypertension incidence,Incidence of upper respiratory tract infection,the incidence of adverse reaction of digestive system was higher than that of Placebo,(3)The effect of Etoricoxib and placebo was better than placebo in the treatment completion rate,Pain VAS score change,phys func score change,the incidence of adverse reaction,the incidence of adverse reaction,Incidence of hypertension,the incidence of upper respiratory tract infection was higher than that of Placebo,(4)compared with placebo,ibuprofen was better than placebo in the treatment completion rate,Pain VAS score change,phys func score change,the incidence of adverse reaction,the incidence of adverse reactions,the incidence of hypertension,The incidence of adverse reaction of digestive system was higher than that of Placebo,(5)compared with placebo,naproxen was better than placebo in the treatment completion rate,Pain VAS score change,phys func score change,and the incidence of adverse reaction,the incidence of adverse reaction,and the incidence of adverse reaction of digestive system.The incidence of adverse reaction of digestive system was higher than that of placebo.The results of SMAA model evaluation were as follows:(1)No preference information was ordered as Etoricoxib>celecoxib>naproxen>ibuprofen>diclofenac>Placebo.(2)Physician preference information(treatment completion rate,Pain score(VAS)change,phys func score change,overall adverse reaction incidence The incidence of adverse reactions caused by medication,the rate of failure,the rate of headache,the incidence of hypertension,the incidence of upper respiratory tract infection and the incidence of adverse reaction of digestive system were sorted as Etoricoxib>celecoxib>naproxen>ibuprofen>diclofenac>placebo(3)Patients preference information(treatment completion rate,pain score(VAS)Change>phys func score change>Drug-induced adverse reaction incidence,headache incidence,incidence of hypertension,upper respiratory tract infection rate total adverse rate of reaction,the rate of ineffective treatment,and the incidence of adverse reaction of digestive system,sorted as Etoricoxib>naproxen>celecoxib>ibuprofen>Diclofenac>placebo.Conclusions:Combined with Bayesian network meta analysis and brat model,Smaa model to carry out comprehensive drug benefit risk assessment,and can be combined with the actual needs of preference sequencing,and finally to the drug benefit risk advantages and disadvantages of ranking,for drug policy to provide objective data support.The evaluation of drug benefit risk is expected to be participated by multi-disciplinary experts,with large data support of relevant monitoring departments to improve the rationality of evaluation results.