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度普利尤单抗治疗成人中重度特应性皮炎的疗效和安全性。

Efficacy and safety of dupilumab for the treatment of moderate-to-severe atopic dermatitis in adults.

作者信息

Xu Xinghua, Zheng Yi, Zhang Xin, He Yanling, Li Chengxin

机构信息

Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.

Department of Dermatology, Chinese PLA General Hospital, Beijing, China.

出版信息

Oncotarget. 2017 Nov 18;8(65):108480-108491. doi: 10.18632/oncotarget.22499. eCollection 2017 Dec 12.

Abstract

OBJECTIVE

Atopic dermatitis is a chronic, relapsing inflammatory skin disease characterized by intense pruritus, excoriations and limited therapies. Dupilumab, a monoclonal antibody against interleukin-4 receptor alpha, is a promising new treatment option for atopic dermatitis. We sought to systematically summarize the efficacy, safety, and influence on quality of life of dupilumab for the treatment of moderate-to-severe atopic dermatitis in adults.

RESULTS

A total of 7 RCTs containing 2705 subjects were identified. Significantly more patients receiving dupilumab (611/1789) achieved Investigator's Global Assessment response compared with the control (89/916; RR, 3.95; < 0.001). Dupilumab was significantly more effective in reducing Eczema Area and Severity Index, peak pruritus numerical rating scale score, and body surface area. Treatment duration rather than administration frequency slightly influenced the efficacy. Dupilumab treatment also contributed to marked improvement in patients' quality of life and psychological symptoms. Incidence of adverse events was similar in dupilumab group and control group.

CONCLUSIONS

Dupilumab is effective and safe for the treatment of moderate-to-severe atopic dermatitis in adults. This meta-analysis supports the role of dupilumab as a primary targeted biologic therapy in adult patients with moderate-to-severe atopic dermatitis.

MATERIALS AND METHODS

We searched Pubmed, Embase, and the Cochrane Library for eligible trials. Only double-blinded randomized controlled trials (RCTs) investigating the efficacy and safety of dupilumab in treating moderate-to-severe atopic dermatitis were included in this analysis. We made a comparison of dupilumab with control based on the pooled relative risk (RR), weighted mean difference, and their corresponding 95% confidence intervals of different measurements.

摘要

目的

特应性皮炎是一种慢性复发性炎症性皮肤病,其特征为剧烈瘙痒、皮肤破损且治疗方法有限。度普利尤单抗是一种抗白细胞介素-4受体α的单克隆抗体,是一种有前景的特应性皮炎新治疗选择。我们旨在系统总结度普利尤单抗治疗成人中重度特应性皮炎的疗效、安全性及对生活质量的影响。

结果

共纳入7项随机对照试验,涉及2705名受试者。与对照组(89/916)相比,接受度普利尤单抗治疗的患者(611/1789)达到研究者整体评估反应的比例显著更高(RR,3.95;P<0.001)。度普利尤单抗在降低湿疹面积和严重程度指数、瘙痒峰值数字评定量表评分及体表面积方面显著更有效。治疗持续时间而非给药频率对疗效有轻微影响。度普利尤单抗治疗也使患者的生活质量和心理症状有显著改善。度普利尤单抗组和对照组的不良事件发生率相似。

结论

度普利尤单抗治疗成人中重度特应性皮炎有效且安全。这项荟萃分析支持度普利尤单抗作为成人中重度特应性皮炎主要靶向生物治疗的作用。

材料与方法

我们在PubMed、Embase和Cochrane图书馆中检索符合条件的试验。本分析仅纳入调查度普利尤单抗治疗中重度特应性皮炎疗效和安全性的双盲随机对照试验(RCT)。我们基于合并相对风险(RR)、加权平均差及其相应的不同测量指标的95%置信区间,对度普利尤单抗与对照组进行比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c054/5752457/e0d070feb5f3/oncotarget-08-108480-g001.jpg

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