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J Rheumatol:生物制剂治疗银屑病关节炎的指炎和附着点炎

2020-01-14 xiangting MedSci原创

汇总分析表明,抗TNF-α制剂对指炎和附着点炎的疗效与新型药物相同(乌司奴单抗、苏金单抗、依克珠单抗)。

具有不同作用机制的生物制剂[肿瘤坏死因子抑制剂(TNF-α)、白介素(IL-12/23IL-17]在随机对照试验(RCT)中显示出对银屑病关节炎的疗效。该研究对这些药物治疗指炎和附着点炎进行了荟萃分析,并将结果与​​美国风湿病学会20ACR20)反应和健康评估问卷-残疾指数(HAQ-DI)评分进行了比较。

研究人员进行了系统文献检索,并使用随机效应模型,对抗TNF-α(英夫利昔单抗、戈利木单抗、阿达木单抗)、抗IL-12/23(乌司奴单抗)和抗IL-17(苏金单抗、依克珠单抗)的RCT进行了荟萃分析。使用Cochrane偏倚风险工具对偏倚进行评估。

汇总分析包括18RCTn = 6981)。TNF-α抑制剂和新型生物制剂(乌司奴单抗、苏金单抗、依克珠单抗)均在第24周时显示出明显的指炎缓解,合并风险比(RRvs安慰剂分别为2.5795CI 1.36-4.84)和1.8895CI 1.33-2.65)。对于24周时附着点炎的缓解,TNF-α抑制剂RR1.9395CI 1.33-2.79),新型生物制剂为1.9595CI 1.60-2.38)。两种类别的生物制剂ACR20反应范围有重叠(TNF-α抑制剂:RR = 2.2395CI 1.60-3.11IL-12/23-17合并:RR = 2.3095CI 1.94-2.72)且生活质量改善评分相似,平均HAQ-DI评分变化分别为-0.2995CI -0.39-0.19)和-0.2695CI -0.31-0.22)。

汇总分析表明,抗TNF-α制剂对指炎和附着点炎的疗效与新型药物相同(乌司奴单抗、苏金单抗、依克珠单抗)。

原始出处:

Ahmed Mourad. Treatment of Dactylitis and Enthesitis in Psoriatic Arthritis with Biologic Agents: A Systematic Review and Metaanalysis. J Rheumatol. January 2020.

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    2020-01-16 lmm397

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