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Arthritis Rheumatol:治疗对中轴型脊柱关节炎放射学进展的影响

2020-02-23 xiangting MedSci原创

尽管在2年和≥4年时未观察到TNFi治疗对AS脊柱放射学进展有明显的保护作用,但仅限于低偏倚风险的研究分析显示,在≥4年时TNFi治疗有保护作用。

这项研究旨在探讨治疗对中轴型脊椎关节炎(axSpA)放射学进展的影响。

研究人员进行全面的数据库检索,以查找评估axSpA放射学进展的研究(特定治疗vs.无特定治疗)。估算研究特异性标化平均差,并使用随机效应模型进行组合。

纳入24项研究。其中使用肿瘤坏死因子抑制剂(TNFi)治疗18项,非甾体抗炎药(NSAIDs8项,苏金单抗1项。2年时(mSASSS差异=-0.7395CI -1.520.12I2 = 28%)和≥4年时(mSASSS差异=-2.0395CI -4.630.72I2 = 63%),TNFi治疗组与生物制剂初治人群的脊柱放射学进展无明显差异。仅限于低偏倚风险研究的敏感性分析显示,在≥4年时有显著差异(mSASSS差异=-2.1795CI -4.19-0.15)。NSAIDs vs.对照组(mSASSS差异=-0.3095CI = -2.621.31I2= 71%)或苏金单抗vs. 生物制剂初治组未观察到显著差异(mSASSS差异=-0.3495CI-0.850.17)。没有足够的nr-axSpASIJ进展研究用于分析。

尽管在2年和≥4年时未观察到TNFi治疗对AS脊柱放射学进展有明显的保护作用,但仅限于低偏倚风险的研究分析显示,在≥4年时TNFi治疗有保护作用。因此,长期TNFi治疗可能对影像学进展有益。在2年时,NSAIDs或苏金单抗没有差异。未来的研究应当探讨生物制剂对早期axSpAnr-axSpA放射学进展,以及长期暴露的影响。

原始出处:

Paras Karmacharya. The Effect of Therapy on Radiographic Progression in Axial Spondyloarthritis: A Systematic Review and Meta‐Analysis. Arthritis Rheumatol. January 2020.

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    2020-02-25 lmm397
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    2020-02-25 zhaojie88
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    2020-02-25 kkunny

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