Arthritis Res Ther:IL-17抑制剂治疗强直性脊柱炎的疗效和安全性如何?

2021-05-03 MedSci原创 MedSci原创

强直性脊柱炎是一种慢性疾病,全世界成年人口中的发病率为9-30人每万人。IL-17是一种促炎症细胞因子,是强直性脊柱炎发病机制的关键因子,因此,IL-17阻断是一种潜在和有效的治疗选择。但是,到目前为

强直性脊柱炎是一种慢性疾病,全世界成年人口中的发病率为9-30人每万人。IL-17是一种促炎症细胞因子,是强直性脊柱炎发病机制的关键因子,因此,IL-17阻断是一种潜在和有效的治疗选择。但是,到目前为止,不同的IL-17抑制剂治疗强直性脊柱炎的安全及效果尚未得到全面的分析。近日,研究人员进行了一项回顾性研究,以系统地评估IL-17抑制剂对活动性强直性脊柱炎患者的疗效和安全性,研究结果已发表于Arthritis Res Ther。

研究人员对有关强直性脊柱炎患者IL-17抑制剂的随机对照试验(RCTs)的文献进行了系统回顾。采用Meta分析来确定IL-17抑制剂在治疗这些患者方面的疗效和安全性。主要终点被预设为在第16周时,ASAS20反应标准至少改善20%的患者比例,次要终点被定义为第16周时的ASAS40。

 

结果,研究共纳入了6项III期随机、双盲、安慰剂对照试验,包括1733名患者(1153名患者接受IL-17抑制剂,包括苏金单抗或依奇珠单抗,而580名患者接受安慰剂作为对照)。在第16周,IL-17抑制剂方案产生的ASAS20反应率(RR=1.63,95%CI 1.45-1.84,p=0.00)和次要终点ASAS40反应率(RR=2.12,95%CI 1.75-2.56,p=0.00)都较安慰剂组有明显增加。在安全性方面,使用IL-17抑制剂治疗后比使用安慰剂治疗后出现了更多的不良事件(RR = 1.11,95% CI 1.01-1.22,p = 0.03)和非严重感染(RR = 1.82,95% CI 1.40-2.37,p < 0.001),但是IL-17抑制剂治疗后没有显示其他不良事件的风险增加,包括死亡、因不良事件而停药或严重不良事件。

综上所述,该研究结果表明,IL-17抑制剂治疗活动性强直性脊柱炎具有良好的反应率,但会增加非严重感染的风险。

 

原始出处:

 

Yufeng Yin, et al., Efficacy and safety of IL-17 inhibitors for the treatment of ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Res Ther. 2020 May 12;22(1):111. doi: 10.1186/s13075-020-02208-w.

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    2021-05-21 zywlvao
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  5. 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    2021-06-12 Morris

    这些不良事件具体比例有多少呢

    0

  6. 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    2021-05-05 zhaojie88
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    2021-05-05 fzwish20000
  8. 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    2021-05-05 jjjiang0202
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    2021-05-03 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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