在牛皮治疗中的生物制药转换:系统性审查和元分析
Miao Zhang1,2, Seokgyeong Hong1,2, Qingyun Wang2
1Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
JAMA dermatology
|August 6, 2025
概括
对许多患者来说,切换牛皮的生物药物是有效的,提供了新的治疗选择. 在改变生物疗法时,对感染的警至关重要,尤其是在不同的作用机制的情况下.
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:
- 牛皮的治疗通常需要因为成本,失败,疲劳或不良影响而切换生物药物.
- 在牛皮中跨类生物切换的有效性和安全性的证据是有限的.
研究的目的:
- 为了评估牛皮患者在初始生物治疗失败后切换到第二种生物治疗的有效性和安全性.
- 综合来自随机临床试验 (RCT) 关于斑块性牛皮的跨类生物切换的数据.
主要方法:
- 在PubMed,Embase和Cochrane图书馆进行系统搜索,截至2025年1月.
- 包括成人斑块牛皮患者在药物类内或药物类之间切换生物药物的RCT.
- 使用随机效应模型根据PRISMA指南进行数据提取和合成.
主要成果:
- 对12661名患者的24项RCT的分析显示,跨类生物切换 (PASI 90 或6.53) 的有效性显著.
- 对于PASI 90 (OR 28.61),PASI 75 (OR 11.11) 和PASI 100 (OR 18.76) 进行实质性的改善.
- 整体安全结果没有显著差异,但在转换为抗IL-23p19,抗IL-17A或抗IL-12/23p40药物时观察到更高的感染风险.
结论:
- 跨类生物切换是大量牛皮患者的有效策略.
- 具有多种机制的新生物药物提供了有前途的治疗途径.
- 需要对更大的队列和更长的随访进行进一步的研究;在切换期间对感染的警至关重要.
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