摘要
目的采用网状Meta分析方法比较Janus激酶(JAK)抑制剂治疗类风湿关节炎(RA)的临床疗效。方法计算机全面检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、维普、万方等数据库,搜索JAK抑制剂治疗RA相关的临床随机对照试验(RCT),检索时限为建库至2021年3月。按照Cochrane 5.1手册推荐的偏倚风险评估工具对纳入的研究进行方法学质量评价,采用Revman 5.3和Stata 14.0软件进行数据分析。结果共纳入27项RCT,合计13 589例RA患者,涉及10个干预措施。网状Meta分析结果显示,与安慰剂相比,JAK抑制剂以及阿达木单抗应用后病情缓解20%、 50%、 70%的患者比率(ACR20、ACR50、ACR70)均显著增加(P <0.05);托法替布10 mg的ACR20、ACR50、 ACR70显著高于阿达木单抗(P <0.05)。托法替布10 mg和peficitinib 150 mg的ACR20、ACR50、ACR70的累计排序概率曲线下面积(SUCRA)排名均为第一和第二。结论 JAK抑制剂治疗RA有良好的临床疗效,其中托法替布10 mg和peficitinib 150 mg疗效较优。
AIM To assess the clinical efficacy of Janus kinase(JAK) inhibitors in the treatment of rheumatoid arthritis(RA) by using a network meta-analysis. METHODS The randomized controlled trials(RCTs) related to JAK inhibitors in the treatment of RA were comprehensively searched from PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP and Wanfang databases by computer. The search time was from the establishment of the database to 2021 March. The methodological quality of the included studies was evaluated according to the risk of bias assessment tool recommended by the Cochrane 5.1 manual, and the Revman 5.3 and Stata 14.0 software were used for data analysis. RESULTS Twenty-seven RCTs were included, with a total of 13 589 RA patients, involving 10 interventions. The results of the network meta-analysis showed that compared with placebo, the rate of remission of 20%, 50%, 70% of RA patients(ACR20, ACR50, ACR70) with JAK inhibitors and adalimumab were significantly increased(P < 0.05). ACR20, ACR50 and ACR70 of tofacitinib 10 mg were significantly higher than those of adalimumab(P < 0.05). The area under the cumulative probability curve(SUCRA) of ACR20, ACR50 and ACR70 indicators of tofacitinib 10 mg and peficitinib 150 mg ranked first and second. CONCLUSION JAK inhibitors have good clinical efficacy in the treatment of RA, among which tofacitinib 10 mg and peficitinib 150 mg have the better efficacy.
作者
范小冬
罗宗伟
张杰
谢星星
FAN Xiao-dong;LUO Zong-wei;ZHANG Jie;XIE Xing-xing(Department of Pharmacy,Xichong County People’s Hospital,Nanchong SICHUAN 637200,China;Department of Pharmacy,Nanbu County People’s Hospital,Nanchong SICHUAN 637300,China;Department of Pharmacy,Ya-an People’s Hospital,Ya-an SICHUAN 625000,China)
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2021年第7期531-539,共9页
Chinese Journal of New Drugs and Clinical Remedies
基金
南充市应用技术研究与开发专项项目(20YFZJZC0004)。
