Comprehensive assessment of 18AA amino acid injections based on Chinese guidelines: A narrative review

By systematically evaluating nine 18AA compounded amino acid injections using a percentage scoring method, we aim to provide a basis for hospitals to select compounded amino acid injections. According to the Rapid Guide for Drug Evaluation and Selection in Chinese Medical Institutions (Second Edition) released in 2023, relevant databases such as PubMed, Cochrane, Embase, drug labels, and clinical guidelines were searched for drug information. We used a percentage scoring method to score the nine 18AA compound amino acid injections marketed in China on 5 dimensions, including pharmacological properties (28 points), efficacy (27 points), safety (25 points), economy (10 points), and other attributes (10 points). We classified them into recommendation levels based on the scoring results, to objectively select and evaluate medicines. The final assessment result scores from highest to lowest were 18AA (71.50 points), 18AA-VII (66.77 points), 18AA-IX (66.63 points), 18AA-I (63.39 points), 18AA-II (61.56 points), 18AA-III (61.23 points), 18AA-V-SF (61.12 points), 18AA-V (58.75 points), and 18AA-IV (55.29 points). In the comprehensive overall assessment of amino acid formulations, 18AA-IX and 18AA-VII scored the highest in pharmacological properties and effectiveness, 18AA-IX and 18AA-V-SF excelled in safety, and 18AA scored the highest in economics and other attributes. When a healthcare organization introduces 18AA compounded amino acid injections to their hospital, they can refer to the assessment results and use the top 3 recommended medications: 18 AA, 18 AA-VII, and 18 AA-IX. Meanwhile, 18AA, which has the highest evaluation score and is >70, should be highly recommended as a new drug introduction and prioritized during drug adjustment and retention.