针对没有局部皮质类固醇的中度至重度无皮炎的向系统疗法的比较有效性:更新的网络元分析
Jonathan I Silverberg1, H Chih-Ho Hong2,3, Brian M Calimlim4
1Department of Dermatology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave NW, Ste 2B-425, Washington, DC, 20037, USA. jonathanisilverberg@gmail.com.
Dermatology and therapy
|September 1, 2023
概括
30毫克的阿巴达西提尼布和200毫克的阿布罗西提尼布是最有效的针对性全身疗法,用于12至16周的中度至重度亚托皮炎 (AD). 这些发现更新了之前的分析,并增加了新的第三阶段试验数据.
科学领域:
- 皮肤病学 皮肤病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 中度至重度的亚托皮性皮肤炎 (AD) 的治疗选择正在扩大.
- 之前的网络元分析 (NMA) 已更新,包括最近的第三阶段试验数据.
- 本分析重点关注作为单一疗法使用的有针对性的全身疗法.
研究的目的:
- 评估针对中度至重度的亚托皮性皮肤炎 (AD) 的向全身疗法的比较疗效.
- 评估没有添加局部皮质类固醇 (TCS) 或局部氨酸抑制剂 (TCI) 的疗法.
- 将最新的第三阶段试验数据纳入更新的NMA.
主要方法:
- 进行了贝叶斯网络元分析 (NMA).
- 包括了lebrikizumab,abrocitinib,baricitinib,dupilumab,tralokinumab和upadacitinib的第三期单疗法试验的数据.
- 根据湿疹区域和严重性指数 (EASI-90,EASI-75),的数值评分表 (ΔNRS ≥ 4) 和研究人员全球评估 (IGA 0/1) 评估的疗效.
主要成果:
- 更新的NMA包括13项安慰剂对照试验,涉及6种向治疗的7105名患者.
- 在12-16周,在所有评估的终点上,upadacitinib 30 mg显示出最高的疗效.
- 其他高度有效的疗法包括abrocitinib 200 mg,upadacitinib 15 mg,dupilumab 300 mg和lebrikizumab 250 mg.
结论:
- 在12至16周的中度至重度AD中,upadacitinib 30 mg和abrocitinib 200 mg仍然是最有效的向全身疗法.
- 新的lebrikizumab第三阶段数据被纳入了这个更新的NMA.
- 这些发现支持医疗保健提供者制定针对AD的个性化治疗计划.
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