抗白细胞介素-17抗体治疗斑块状银屑病疗效和安全性的网状Meta分析  

Efficacy and safety of an ti-interleukin-17 antibody for treatment of patients with plaque psoriasis:a network meta-analysis

作　　者：罗宗伟[1] 范小冬 孔文强 张春燕[3] LUO Zong-wei;FAN Xiao-dong;KONG Wen-qiang;ZHANG Chun-yan(Department of Pharmacy,Xichong County People's Hospital,Xichong SICHUAN 637200,China;School of Pharmacy,Southwest Medical University,Luzhou SICHUAN 646000,China;School of Pharmacy,North Sichuan Medical Collage,Nanchong SICHUAN 637000,China)

机构地区：[1]西充县人民医院药学部,四川西充637200 [2]西南医科大学药学院,四川泸州646000 [3]川北医学院药学院,四川南充637000

出　　处：《中国新药与临床杂志》2018年第12期711-720,共10页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的采用网状Meta分析方法评价抗白细胞介素-17 (IL-17)抗体治疗斑块状银屑病的疗效与安全性。方法计算机检索PubMed、 Cochrane Library、 EBSCO、 EMbase、中国生物医学文献数据库、中国学术期刊全文数据库、维普中文科技期刊数据库及万方数据库中关于抗IL-17抗体(苏金单抗、布罗达单抗、艾克珠单抗)治疗中重度斑块状银屑病的临床随机对照试验(RCT),检索时限从2000年1月至2018年2月。采用Stata14.0和Revman 5.3软件进行网状Meta分析。结果共纳入15项RCT,合计12 804例患者。网状Meta分析结果显示,抗IL-17抗体组银屑病皮损面积和严重性指数积分下降≥75%的患者人数(PASI75)指标均显著优于安慰剂组和依那西普组(P <0.05)。苏金单抗300 mg组、布罗达单抗210 mg组、艾克珠单抗q4wk组、艾克珠单抗q2wk组PASI75指标均显著优于优特克单抗组(P <0.05)。苏金单抗150 mg组和布罗达单抗140 mg组PASI75指标与优特克单抗组相当,差异无显著意义(P> 0.05)。采用累积排序概率图下面积值(SUCRA)对9组干预措施PASI75指标进行排序,结果显示艾克珠单抗q2wk组(SUCRA=96.2%)疗效最佳,后面依次为布罗达单抗210 mg组(81.8%)、苏金单抗300 mg组(73.0%)、艾克珠单抗q4wk组(72.9%)、苏金单抗150 mg组(47.9%)、优特克单抗组(36.9%)、布罗达单抗140 mg组(29.0%)、依那西普组(12.5%)、安慰剂组(0.0)。在安全性方面, 9组干预措施两两比较因不良事件退出率均相当,差异无显著意义(P> 0.05)。结论抗IL-17抗体治疗斑块状银屑病疗效肯定且优于依那西普,安全性亦较好。AIM To assess the efficacy and safety of anti-interleukin-17(anti-IL-17)antibody in the treatment of plaque psoriasis by using network nleta-analysis.METHODS The randomized controlled trials (RCTs)of anti-IL-17 antibody (secukinumab,brodalumab,ixekizumab)in the treatment of plaque psoriasis were searched from PubMed,Coehrane Library,EBSCO,EMbase,CBM,CNKI,VIP,Wangfang database by computer.Data were collected from January 2000 to February 2018.Net recta-analysis was performed using Stata 14.0 and Revman 5.3.RESULTS A total of 15 RCTs involving 12804patients were included.The number of patients with psoriasis area and severity index score >175%(PASI75)indicators in the anti-IL-17 antibody group were better than that in the placebo and etanercept group (P <0.05).PASI75 indicators in the seeukinurnab 300mg group,brodalumab 210 mg group,ixekizumab q4wk group and ixekizumab q2wk group were better than that in the ustekinumab group (P <0.05).PASI75 indicators in the secukinumab 150 mg group and brodalumab 140 mg group were comparable to the ustekinumab group (P >0.05).The results of the surface under the cumulative ranking curve (SUCRA)showed that the efficacy of the ixekizumab q2wk group was the best (SUCRA =96.2%),followed by the brodalumab 210mg group (81.8%),the secukinumab 300mg group (73.0%),ixekizumab q4wk group (72.9%),secukinumab 150 mg group (47.9%),ustekinumab grout)(36.9%), brodalumab 140mg group (29.0%),etanercept group (12.5%)and placebo group (0.0).In terms of safety, there was no significant difference in the rate of withdrawal due to adverse events in any of the 9 interventions (P >0.05).CONCLUSION Anti-IL-17 antibody has positive effects in treatment of plaque psoriasis and is superior to etanereept,while the safety is also better.

关 键 词：白细胞介素17 苏金单抗 布罗达单抗 艾克珠单抗 银屑病 网状Meta分析 

分 类 号：R593.2[医药卫生—内科学]