Meta-analysis and Pharmacoeconomics Evaluation of Valsartan in the Treatment of Chronic Kidney Disease with Hypertension

OBJECTIVE  To study the efficacy and safety of valsartan in the treatment of chronic kidney disease complicated with hypertension based on meta-analysis, and to conduct pharmacoeconomic research, so as to provide guidance for rational drug use and provide evidence for making relevant healthcare decisions.

METHODS  PubMed, Embase, The Cochrane Library, CNKI, Wanfang, Weipu and other databases were searched to collect literature on valsartan in the treatment of chronic kidney disease complicated with hypertension, then meta-analysis was conducted, and the incremental cost-effectiveness ratio(ICER) was used for economic evaluation, and sensitivity analysis were performed.

RESULTS  A total of 8 valid literatures including 1586 patients were included. Meta-analysis showed that valsartan in combination with nifedipine controlled release tablets improved the measures SBP, DBP and UAER, and decreased adverse effects, and the differences were statistically significant(P<0.01), when compared to nifedipine controlled release tablets alone. From the health system perspective, and using the blood pressure value, UAER value, and blood pressure reduction efficiency as the effectiveness indicators, the results of the pharmacoeconomics evaluation showed that valsartan alone or in combination with nifedipine controlled release tablets had an ICER of less than one times per capita disposable income or had better effectiveness with lower costs when compared to other regimens. The results of the sensitivity analysis were basically consistent with the results of the basic analysis.

CONCLUSION  Compared with other drug regimens, valsartan alone or in combination with nifedipine controlled release tablets has certain advantages in efficacy and economy in the treatment of chronic kidney disease and hypertension, and the probability of adverse reactions caused by the combination treatment of valsartan is decreased and the safety is higher. However, due to limitations in the number and quality of included studies, these conclusions need to be validated by more high-quality studies.