慢性斑块牛皮的全身药理疗法:一个网络元分析
Emilie Sbidian1,2,3, Anna Chaimani4,5, Robin Guelimi1,3
1Department of Dermatology, Hôpital Henri Mondor, Créteil, France.
The Cochrane database of systematic reviews
|July 12, 2023
概括
对于中度至重度的牛皮,生物药物如infliximab,bimekizumab,ixekizumab和risankizumab是最有效的皮肤清除. 这些牛皮治疗方法的安全数据有限,需要更多的对比试验.
科学领域:
- 皮肤病学和免疫学
- 药理学和治疗学 药理学和治疗学
- 证据综合和元分析
背景情况:
- 牛皮是一种慢性免疫媒介疾病,影响皮肤和/或关节,显著影响生活质量.
- 目前的治疗方法可以控制症状,但对它们相对益处的直接比较数据有限.
- 网络元分析 (NMA) 用于综合比较各种牛皮治疗方法的试验证据.
研究的目的:
- 为了比较非生物系统性药物,小分子和生物制剂对中度至重度牛皮的益处和危害.
- 根据有效性 (PASI 90) 和安全性 (严重不良事件) 来对这些牛皮治疗进行排名.
- 根据最近的证据,提供针对牛皮的全身治疗方法的最新排名.
主要方法:
- 一个更新的生活系统审查和随机对照试验 (RCT) 的网络元分析 (NMA) 到2022年10月.
- 包括患有中度至严重斑块性牛皮的成年人,将全身治疗与安慰剂或活性剂进行比较.
- 主要结局:牛皮的区域和严重性指数 (PASI) 在诱导过程中达到90和严重不良事件 (SAE).
主要成果:
- 所有评估的干预措施 (非生物制剂,小分子,生物制剂) 显示PASI 90比安慰剂更高.
- 与所有其他干预措施相比,抗IL17治疗显示出更高的PASI 90率.
- 在PASI 90中,infliximab,bimekizumab,ixekizumab和risankizumab的有效性最高,证据确定性高;安全性数据有限,确定性低至中等.
结论:
- 在诱导治疗期间,生物药物infliximab,bimekizumab,ixekizumab和risankizumab对于在中度至重度的牛皮中实现PASI 90非常有效.
- 国家药物管理局的证据主要用于短期诱导,并不能完全捕捉长期结果或安全性.
- 需要进一步的对比试验和非随机研究来评估不同患者群体的长期安全性和有效性.
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