生物和向小分子药物的序列线的有效性在牛皮:一个系统的审查和元分析
Charlotte E Gollins1,2, Rosie Vincent1,3, Caoimhe Fahy1
1Dermatology Department Royal United Hospitals Bath NHS Foundation Trust Bath UK.
Skin health and disease
|April 5, 2024
概括
生物药物和向小分子在连续的牛皮治疗中表现出有效性,甚至高达第四线. 证据质量各不相同,除了二线疗法之外的数据有限.
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
背景情况:
- 牛皮是一种慢性炎症性皮肤疾病.
- 顺序生物和向小分子疗法用于中度至重度的牛皮.
- 关于这些治疗方法在第一线之外的有效性的证据正在不断发展.
研究的目的:
- 系统地评估目前关于顺序生物和向小分子药物治疗牛皮的疗效的证据,超出一线治疗范围.
- 评估跨多种疗法线 (1至4) 的治疗疗效.
主要方法:
- 在Medline,Embase和文献数据库中进行系统的文献搜索 (2022年10月-12月).
- 包括在成人牛皮患者中评估超出第一线的生物/小分子有效性的研究.
- 数据提取和偏差评估 (非随机干预研究/Cochrane RoB2中的偏差风险),然后在12-16周对PASI75/90/100进行随机效应比例元分析.
主要成果:
- 20项研究 (19项观察性研究,1项RCT分分析;n=6495) 符合资格标准.
- 分析显示,PASI75的总成绩率为61% (第一行),56% (第二行),79% (第三行) 和61% (第四行).
- PASI90/100元分析表明,顺序线的有效性没有下降;然而,证据质量主要是低的和观察性的,第二线以外的数据有限.
结论:
- 生物药物在牛皮治疗中表现出高达第四线的有效性.
- 对于超出第一线的治疗方法,现有的证据主要是观察性的,质量不佳.
- 需要进一步进行高质量的研究来证实有效性,特别是在第二线以外的治疗中.
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