吞局部皮质类固醇在异性食管炎中的比较有效性和安全性:一个网络元分析
Alfredo J Lucendo1,2,3,4, Ángel Arias2,3,4,5,6, Celia Álvarez-Bueno7
1Department of Gastroenterology, Hospital General de Tomelloso, 13700 Tomelloso, Spain.
Journal of clinical medicine
|November 13, 2025
概括
布德塞尼德口溶性片是最有效的吞局部皮质类固醇 (STCs),用于在性食道炎 (EoE) 中实现组织学缓解. 然而,其他布德索尼德配方在症状和内镜改善方面表现出优越性,所有STC都显示出与安慰剂或PPI相比的安全性.
科学领域:
- 胃肠病学 胃肠病学
- 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:
- 吞局部皮质类固醇 (STC) 是对性食道炎 (EoE) 的主要治疗方法.
- 以前的随机对照试验 (RCT) 显示出不同的表现和剂量,需要进行比较分析.
- 了解不同STC选项的比较安全性和有效性对于优化EdE管理至关重要.
研究的目的:
- 进行网络元分析,比较各种基于STC的EoE治疗方法的疗效和安全性.
- 评估STC与安慰剂和质子抑制剂 (PPI) 相比,用于诱导和维持EoE缓解.
- 评估组织学,症状和内镜结局,以及不良事件.
主要方法:
- 从数据库开始到2024年7月,对EoE的STC进行RCT的系统文献搜索.
- 网络元分析以比较疗效 (组织学缓解,症状改善,内镜EREFS) 和安全性 (不良事件).
- 使用聚合风险比率 (RRs) 和 95% 置信区间 (CI) 的平均差异来衡量结果.
主要成果:
- 布德塞尼德1毫克口腔可分散片在所有组织学缓解终点中显示出最高的排名.
- 来自吸入装置的布德索尼德在改善症状方面优于安慰剂;粘性布德索尼德悬浮改善了内镜.
- 没有任何STC配方显示出与增加不良事件风险 (淋巴瘤,上腺抑制) 的显著关联.
结论:
- 布德索尼德口溶性片是达到EOE组织学缓解的最佳方法.
- 症状和内镜改善可能更好地通过其他布德索尼德配方实现.
- STC治疗与安慰剂或PPI一样安全,用于治疗异性食道炎.
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