药物对抗活性乙性食道炎的比较:系统性审查和网络元分析
Pierfrancesco Visaggi1, Brigida Barberio2, Giulio Del Corso3
1Department of Translational Research and New Technologies in Medicine and Surgery, Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy.
Gut
|July 25, 2023
概括
治疗异性食道炎 (EoE) 的药物的疗效尚不清楚. 这种网络的元分析发现lirentelimab和budesonide (口服分解片或口服悬浮剂) 对于EoE治疗是有效的,尽管试验异质性阻碍了明确的层次结构.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 由于相对疗效尚不清楚,性食管炎 (EOE) 缺乏首选药物建议.
- 目前的治疗选择包括质子抑制剂,局部类固醇和生物药物.
研究的目的:
- 进行一个最新的网络元分析,比较各种药物的有效性,以治疗活跃的乙酸性食道炎 (EoE).
- 根据它们在实现组织学和症状缓解方面的有效性来对药物进行排名.
主要方法:
- 系统地搜索多个数据库 (MEDLINE,Embase,Cochrane) 到2023年6月进行随机对照试验 (RCT).
- 包括对成人和青少年具有活性EoE的药物相互比较或安慰剂的RCT.
- 计算了聚合的相对风险和95%CI,并使用P分数对药物进行排名.
主要成果:
- 利伦特利马布 (每月1毫克/公斤) 在组织学缓解 (≤6种乙素/HPF) 方面排名第一.
- 布德塞尼德口服分解片 (BOT) (1毫克两次) 在组织学缓解方面排名第一 (≤15种乙素/HPF).
- BOT和布德索尼德口服悬浮剂 (BOS) 在症状和内镜改善方面表现出比安慰剂显著的疗效.
结论:
- 大多数评估的药物在治疗异性食道炎 (EOE) 方面比安慰剂更有效.
- 试验资格和结果指标的显著异质性使得建立明确的治疗层次结构变得复杂.
- 需要进一步标准化试验设计,以建立首选治疗指南.
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