Thorax:白介素抑制剂治疗COVID-19的疗效分析

2021-02-14 MedSci原创 MedSci原创

前瞻性研究中tocilizumab治疗与较低的死亡率相关,但对于其他结局尚无定论。目前尚无证据证明anakinra、sarilumab或siltuximab在COVID-19治疗中的疗效。

越来越多的证据表明严重COVID-19患者免疫应答过度激活,有几项研究探究了免疫调节对COVID-19的治疗作用。近日,胸部疾病领域权威杂志Thorax上发表了一篇研究文章,研究人员通过系统评价和荟萃分析评估了特异性白介素抑制剂用于COVID-19治疗的有效性。

研究人员检索电子数据库,时间截止至2021年1月7日,以确定采用免疫调节剂(anakinra、sarilumab、siltuximab和tocilizumab)用于COVID-19治疗的研究。该研究的主要结局干预后第15天按序贯量表测量的疾病严重程度和出院天数。该研究的关键次要结局包括总体死亡率。

该分析共纳入了71项研究,总计22058例患者,其中6项研究为随机试验。大多数研究探讨了接受tocilizumab治疗的患者预后(60/71)。在前瞻性研究中,tocilizumab与未经调整的生存期改善有关(风险比为0.83,95%CI为0.72-0.96,I2=0.0%),但未发现对其他结局具有益处。在回顾性研究中, tocilizumab与序贯量表衡量的较轻的预后(总体OR为1.34,95%CI为1.10至1.64,I2=98%)和调整后的死亡风险(HR为0.52,95%CI为0.41至0.66,I2=76.6%)相关。住院时间的平均差异为0.36天(95%CI为-0.07至0.80,I2=93.8%)。回顾性研究存在很大的异质性,应谨慎解释估计值。其他免疫调节剂的疗效与tocilizumab相似,但数据不足,无法进行荟萃分析。

由此可见,前瞻性研究中tocilizumab治疗与较低的死亡率相关,但对于其他结局尚无定论。目前尚无证据证明anakinra、sarilumab或siltuximab在COVID-19治疗中的疗效

原始出处:

Fasihul A Khan,et al.Systematic review and meta-analysis of anakinra, sarilumab, siltuximab and tocilizumab for COVID-19.Thorax.2021.https://thorax.bmj.com/content/early/2021/02/11/thoraxjnl-2020-215266

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    2021-05-31 jklm09
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    2021-02-15 健康达人

    #tocilizumab#可能是有益的,以色列将CD24进行吸入性治疗,据说效果超级的好

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1852603, encodeId=3e6c185260321, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon May 31 15:28:33 CST 2021, time=2021-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647293, encodeId=b379164e2937b, content=<a href='/topic/show?id=e9bae04003f' target=_blank style='color:#2F92EE;'>#疗效分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70400, encryptionId=e9bae04003f, topicName=疗效分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=219323401160, createdName=rebeccajiejie, createdTime=Wed Mar 24 04:28:33 CST 2021, time=2021-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1372150, encodeId=8b7213e21505d, content=<a href='/topic/show?id=6ca1e1621c4' target=_blank style='color:#2F92EE;'>#白介素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71621, encryptionId=6ca1e1621c4, topicName=白介素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0e95336, createdName=budeshao, createdTime=Tue Feb 16 13:28:33 CST 2021, time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924720, encodeId=c0cb924e2034, content=<a href='/topic/show?id=8c2a1e616fd' target=_blank style='color:#2F92EE;'>#tocilizumab#</a>可能是有益的,以色列将CD24进行吸入性治疗,据说效果超级的好, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17616, encryptionId=8c2a1e616fd, topicName=tocilizumab)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=健康达人, createdTime=Mon Feb 15 11:13:16 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032798, encodeId=fc1b1032e98b7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Feb 15 01:28:33 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924628, encodeId=126c9246282e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26e45460284, createdName=ms3000001997244174, createdTime=Sun Feb 14 23:51:11 CST 2021, time=2021-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924625, encodeId=951292462544, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Feb 14 23:11:09 CST 2021, time=2021-02-14, status=1, ipAttribution=)]
    2021-02-15 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1852603, encodeId=3e6c185260321, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon May 31 15:28:33 CST 2021, time=2021-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1647293, encodeId=b379164e2937b, content=<a href='/topic/show?id=e9bae04003f' target=_blank style='color:#2F92EE;'>#疗效分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70400, encryptionId=e9bae04003f, topicName=疗效分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=219323401160, createdName=rebeccajiejie, createdTime=Wed Mar 24 04:28:33 CST 2021, time=2021-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1372150, encodeId=8b7213e21505d, content=<a href='/topic/show?id=6ca1e1621c4' target=_blank style='color:#2F92EE;'>#白介素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71621, encryptionId=6ca1e1621c4, topicName=白介素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0e95336, createdName=budeshao, createdTime=Tue Feb 16 13:28:33 CST 2021, time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924720, encodeId=c0cb924e2034, content=<a href='/topic/show?id=8c2a1e616fd' target=_blank style='color:#2F92EE;'>#tocilizumab#</a>可能是有益的,以色列将CD24进行吸入性治疗,据说效果超级的好, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17616, encryptionId=8c2a1e616fd, topicName=tocilizumab)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=健康达人, createdTime=Mon Feb 15 11:13:16 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032798, encodeId=fc1b1032e98b7, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Feb 15 01:28:33 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924628, encodeId=126c9246282e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26e45460284, createdName=ms3000001997244174, createdTime=Sun Feb 14 23:51:11 CST 2021, time=2021-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924625, encodeId=951292462544, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Feb 14 23:11:09 CST 2021, time=2021-02-14, status=1, ipAttribution=)]
    2021-02-14 ms3000001997244174

    学习了

    0

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    2021-02-14 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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