维得利珠单抗对中重度溃疡性结肠炎患者有效性与安全性的系统综述和meta分析  

Efficacy and Safety of Vedolizumab in Patients With Moderate-to-severe Ulcerative Colitis:A Systematic Review and Meta-analysis

作　　者：王璐[1] 江振宇[1] 王觅柱[1] 刘飞飞 白露 WANG Lu;JIANG Zhenyu;WANG Mizhu;LIU Feifei;BAI Lu(Department of Gastroenterology,the Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science&Technology,Baotou,Inner Mongolia,014030;Department of Anesthesiology,the Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science&Technology,Baotou,Inner Mongolia,014030)

机构地区：[1]内蒙古科技大学包头医学院第二附属医院消化科,014030 [2]内蒙古科技大学包头医学院第二附属医院麻醉科,014030

出　　处：《胃肠病学》2022年第1期32-38,共7页Chinese Journal of Gastroenterology

基　　金：内蒙古自治区科技计划(2021GG0232);内蒙古自治区科技创新引导项目计划。

摘　　要：背景:生物制剂已成为中重度溃疡性结肠炎(UC)重要的治疗方法,研究表明维得利珠单抗(VDZ)具有较好的疗效。目的:系统评价VDZ对中重度UC的有效性和安全性。方法:检索PubMed、Web of Science、EBSCO、The Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献服务系统(SinoMed)等数据库中关于VDZ、抗肿瘤坏死因子-α(TNF-α)单抗治疗中重度UC的文献,检索时限均从建库至2021年8月。按照纳入与排除标准筛选文献、提取数据,采用RevMan 5.4软件进行meta分析。结果:最终纳入11项研究、3921例患者。Meta分析结果显示,与抗TNF-α组相比,VDZ组临床应答率(OR=2.14,95%CI:1.73~2.64,P<0.00001)、临床缓解率(OR=1.67,95%CI:1.42~1.96,P<0.00001)、内镜缓解率(OR=1.62,95%CI:1.29~2.03,P<0.0001)、组织学缓解率(OR=1.98,95%CI:1.61~2.44,P<0.00001)明显升高,而两组不良反应发生率无明显差异(OR=0.51,95%CI:0.26~1.01,P=0.05)。结论:与抗TNF-α单抗相比,VDZ治疗中重度UC的疗效更确切,而不良反应发生率无明显差异。Background:Biological agents have become an important treatment for moderate-to-severe ulcerative colitis(UC).Studies have shown that vedolizumab(VDZ)has good efficacy.Aims:To systematically evaluate the efficacy and safety of VDZ in the treatment of moderate-to-severe UC.Methods:Studies on VDZ,anti-tumor necrosis factor(TNF)-αin treatment of moderate-to-severe UC were retrieved from PubMed,Web of Science,EBSCO,The Cochrane Library,CNKI,SinoMed from the date of database establishment to August 2021.According to inclusion and exclusion criteria,literatures were screened and extracted.RevMan 5.4 software was used to conducted meta-analysis.Results:Eleven studies involving 3921 patients were included.Meta-analysis showed that the clinical response rate(OR=2.14,95%CI:1.73-2.64,P<0.00001),the clinical remission rate(OR=1.67,95%CI:1.42-1.96,P<0.00001),the endoscopic response rate(OR=1.62,95%CI:1.29-2.03,P<0.0001),and the histological response rate(OR=1.98,95%CI:1.61-2.44,P<0.00001)in VDZ group were significantly higher than those in anti-TNF-αgroup.However,no significant difference in incidence of adverse reactions was found between the two groups(OR=0.51,95%CI:0.26-1.01,P=0.05).Conclusions:Compared with anti-TNF-α,VDZ is more effective in the treatment of moderate-to-severe UC,and there is no significant difference in incidence of adverse reactions.

关 键 词：结肠炎 溃疡性 肿瘤坏死因子Α 维得利珠单抗 治疗 META分析 

分 类 号：R574.62[医药卫生—消化系统]